Payer: Page 62
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COVID-19 among top US telehealth diagnoses for first time
Mental health conditions continue to be the No. 1 telehealth diagnosis nationwide, according to new data from nonprofit Fair Health.
By Rebecca Pifer • March 8, 2021 -
"Medical disposable masks on wooden background" by Marco Verch Professional Photographer and Speaker is licensed under CC BY 2.0
Becerra tells Californians to dispute COVID-19 fees from providers
Patients charged a "COVID fee" from a recent visit should contact their insurer and request a reimbursement, according to a statement from the state's attorney general, who is the nominee for HHS secretary.
By Hailey Mensik • March 4, 2021 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Support for telehealth Medicare reimbursement gains steam in Congress
Tuesday's House committee mirrored similar Senate panels, in that a permanent expansion to a greater swath of the population enjoys bipartisan support, but legislators are split on what form it should take.
By Rebecca Pifer • March 3, 2021 -
Hillrom steps back from $375M BardyDx deal on reimbursement setback
The hospital products maker said a Medicare contractor's unexpected drop in payment rates for BardyDx's cardiac monitoring technology meant closing conditions for the transaction had not been satisfied.
By Susan Kelly • March 1, 2021 -
National Institute of Allergy and Infectious Diseases. (2020). "Novel Coronavirus SARS-CoV-2" [Micrograph]. Retrieved from Flickr.
CMS moves to stop COVID-19 testing denials, cost sharing in private plans
Congress required comprehensive health plans to cover COVID-19 tests without cost sharing, prior authorization or medical management last year, only for guidance to create uncertainty about the rules.
By Nick Paul Taylor • March 1, 2021 -
Permission granted by Cigna
Cigna health services arm Evernorth completes buy of telehealth vendor MDLive
The deal closed Monday, the payer said. MDLive will operate as part of Evernorth's portfolio that also includes pharmacy benefit manager Express Scripts.
By Rebecca Pifer • Updated April 20, 2021 -
Retrieved from The White House/YouTube on January 21, 2021
ACLA urges Biden to fund uninsured COVID-19 testing, close coverage loopholes
The plea from the trade group for Quest and LabCorp is the latest in a row between labs and insurers over paying for the diagnostics and comes as a $2 billion federal testing fund runs dry.
By Nick Paul Taylor • Feb. 24, 2021 -
SCOTUS drops Medicaid work requirement arguments at Biden administration's request
The administration is in the process of reversing the policy, which 12 states received federal approval to test. No such programs are currently active, having run into legal and administrative challenges even prior to the pandemic.
By Rebecca Pifer • Updated March 11, 2021 -
Oscar Health eyes $6.7B valuation with upcoming IPO
Even though the startup added members to plans and expanded to several states last year, it faces flagging financial performance that could tamp down investor enthusiasm.
By Rebecca Pifer • Feb. 22, 2021 -
Retrieved from Manatt on February 18, 2021
Obama admin alum Chiquita Brooks-LaSure picked to head CMS
Brooks-LaSure will have a lot on her plate. Biden during his campaign ran on expanding the role of the Affordable Care Act and perhaps attempting to build in a public option or lowered Medicare age eligibility.
By Shannon Muchmore • Updated Feb. 19, 2021 -
Anthem-backed digital startup Sharecare goes public in $3.9B blank check deal
The startup, launched by WebMD founder Jeff Arnold and medical TV personality Mehmet Oz, will merge with special purpose acquisition company Falcon Capital Acquisition and is the latest in the digital health SPAC craze.
By Rebecca Pifer • Feb. 17, 2021 -
Payer profits nosedived in Q4 on increased COVID-19 expenses
Still, major insurers ended 2020 in the black, buoyed by the pullback in utilization during earlier quarters.
Feb. 17, 2021 -
Biden admin begins plan to rescind Medicaid work mandates in win for providers
The policies threatened to lower hospitals' Medicaid revenues as enrollees lost coverage, raising uncompensated care costs. But lawsuits and the pandemic have kept states from implementing the controversial Trump-era requirements.
By Samantha Liss • Feb. 16, 2021 -
CVS to jump back into individual ACA markets in 2022
The health giant has yet to disclose specific geographies or the cost of the plans, with newly installed CEO Karen Lynch telling investors Tuesday to expect more details in the second quarter.
By Rebecca Pifer • Feb. 16, 2021 -
Molina expects utilization to remain depressed in 2021
Looking ahead, executives seemed cautiously optimistic for this year but noted headwinds from the COVID-19 pandemic will persist. Bright spots for the payer include the recently announced ACA special enrollment period.
By Samantha Liss • Feb. 11, 2021 -
As COVID-19 becomes a business, vaccine makers confront thorny pricing questions
Yearly vaccinations could be required after the pandemic ebbs. Will drugmakers change how they approach pricing their shots?
By Jonathan Gardner • Feb. 10, 2021 -
Medicare DME competitive bidding in doubt after failed round
Cowen analysts said a recent report found steep rate hikes, leading them to conclude the program is no longer such a big threat to companies like Baxter, ResMed and Philips.
By Nick Paul Taylor • Feb. 10, 2021 -
Centene to ax 3,000 jobs as run of profitable quarters ends
After months of benefiting from deferred care like many other insurers, Centene reported a loss in the fourth quarter in part due to higher COVID-19 testing and treatment costs.
By Samantha Liss • Feb. 9, 2021 -
Oklahoma selects 4 private payers to manage Medicaid for $2B, faces legal suit
The state maintains the switch will improve costs while maintaining access, but the move to cede Medicaid control to for-profit entities is highly controversial.
By Rebecca Pifer • Feb. 9, 2021 -
Adeline Kon/Healthcare Dive
Fitch: Biden's healthcare plans could boost nonprofit hospitals
The ratings agency cited administration plans to bolster the Affordable Care Act, which could reverse the increased number of uninsured people, as among the factors driving brighter prospects.
By Ron Shinkman • Feb. 4, 2021 -
Cigna's COVID-19 costs outweighed deferred care savings for first time in Q4
CEO David Cordani told investors he expects 2021 to be a "year of transition" as coronavirus vaccine rollouts will "continue to tax an already overburdened healthcare system."
By Shannon Muchmore • Feb. 4, 2021 -
UnitedHealth CEO Dave Wichmann steps down, replaced by Optum head Andrew Witty
Wichmann's retirement ends his relatively short tenure at the diversified healthcare giant, and results in a leadership shakeup with Witty immediately taking the reins.
By Rebecca Pifer • Feb. 4, 2021 -
Medicare buy-in for older adults could cut health costs, increase coverage value: Urban Institute
A Medicare buy-in is not a specific prong of President Joe Biden's health policy agenda, but there are currently two proposals in Congress designed to build upon the ACA.
By Rebecca Pifer • Feb. 3, 2021 -
Humana posts Q4 loss after uptick in COVID-19 care, tests
The payer's executives said depressed utilization last year created unique challenges for 2021, particularly in the Medicare book of business.
By Samantha Liss • Feb. 3, 2021 -
Anthem to acquire largest Medicare Advantage plan in Puerto Rico
The deal also nets the insurer the second-largest Medicaid plan there and a network of specialized clinics.
By Samantha Liss • Feb. 2, 2021
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