Payer: Page 64


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    Chris Hondros via Getty Images
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    After Haven flop, JPMorgan Chase unveils solo healthcare venture

    Morgan Health, somewhat of a successor to the defunct collaboration with Amazon and Berkshire Hathaway, comes armed with $250 million to invest in innovations in employer coverage and advancements in health equity.

    By Dan Ennis , May 21, 2021
  • Anthem, Epic launch data-sharing partnership

    The collaboration will integrate Epic's payer platform into Anthem's operating system, in a bid to streamline administrative processes like electronic prior authorization while harnessing more real-time data on patient behaviors.

    By , May 20, 2021
  • A physician holds a telehealth session with a patient via computer.
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    [Photograph]. Retrieved from Regional Health Command Atlantic.
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    More than 1 in 4 Medicare beneficiaries used telehealth between summer and fall last year

    A Kaiser Family Foundation report also found a majority of beneficiaries using virtual care accessed it over the phone, hinting at continued demand for audio-only telehealth beyond the COVID-19 public health emergency.

    By May 20, 2021
  • Exact Sciences precision oncology lab
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    Courtesy of Exact Sciences
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    US panel trims colorectal cancer screening age, broadening payer mandate

    The action means private insurers have to cover the screening of adults aged 45 to 49 years under the Affordable Care Act.

    By Nick Paul Taylor • May 19, 2021
  • A picture of the exterior of a CVS Pharmacy with the logo and name in view.
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    Bruce Bennett via Getty Images
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    Former Aetna exec becomes CVS CFO

    Incoming finance chief Shawn Guertin was originally expected to take the job after the retail behemoth's 2018 acquisition of Aetna, but initially declined, citing personal and family reasons.

    By Jane Thier • May 18, 2021
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    Kena Betancur via Getty Images
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    Clover net loss balloons due to higher-than-expected medical costs

    An ongoing SEC probe could pose a significant risk to the payer, which gets most of its revenue from government programs.

    By May 18, 2021
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    Getty Images
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    Sponsored by ZS

    Life sciences' role in achieving health equity

    How can we mend the industry's foundation? And, what role can life sciences companies play in healthcare's quest to improve healthcare for all?

    By Nan Gu and Harshil Gagnani • May 17, 2021
  • A picture of the exterior of the US Department of Health and Human Services. In front of the building is a black sign designating the building's name.
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    Alex Wong via Getty Images
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    CMS again delays breakthrough device payment rule in nod to skeptics

    Medtech manufacturers pushed for the MCIT rule, but high-profile detractors like payer lobby America's Health Insurance Plans and doctor groups drove CMS to delay implementation, citing potential risks to Medicare beneficiaries.

    By Nick Paul Taylor • May 17, 2021
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    Fotolia
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    Almost all major US payers hiked forecasts following Q1, hinting at 2021 optimism despite COVID-19

    Humana was the only major insurer not to increase its full-year earnings outlook following a strong quarterly showing in the benefits sector.

    May 12, 2021
  • Cigna signals optimism for 2021 as it raises forecasts despite ongoing pandemic

    The insurer bested Wall Street expectations in the first quarter with $1.2 billion in profit on $41 billion in revenue.

    By May 7, 2021
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    Drew Angerer via Getty Images
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    ACA special enrollment period sign-ups surged in April

    The Biden administration began the SEP primarily to help people who have lost coverage due to the COVID-19 pandemic and related economic fallout.

    By May 7, 2021
  • Amwell physician conducts visit with patient
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    Courtesy of Amwell
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    Cigna adds in-network virtual mental healthcare, highlighting focus on treatment access

    Ginger provides Cigna customers with behavioral health coaching, therapy and psychiatry services through its app.

    By Katie Clarey • May 5, 2021
  • A picture of the exterior of a CVS Pharmacy with the logo and name in view.
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    Bruce Bennett via Getty Images
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    CVS profit up 10%, but warns vaccine hesitancy could dampen earnings

    The diversified health behemoth beat Wall Street quarterly forecasts with revenue of $69.1 billion, raising its full-year guidance as a result.

    By May 4, 2021
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    Fotolia
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    COVID-19 spurred growing profitability in insurance markets last year, KFF says

    Still, the Kaiser Family Foundation report stressed the pandemic's long-term financial ramifications on insurers are uncertain, as a bounceback in utilization and shifting regulatory requirements could dampen future income.

    By May 3, 2021
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    Sponsored by Pulse8

    Using risk adjustment analytics to precision target interventions

    Dynamic intervention planning helps payers save time and money while reducing 20-30% interventions.

    By Scott Stratton, MPH • May 3, 2021
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    Fotolia
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    Kentucky must rebid Medicaid contracts again, judge rules

    This ruling puts six insurers at risk of losing their lucrative contracts with the state. It's unclear when the state will rebid the work.

    By April 30, 2021
  • Molina membership growth propelled revenue, profit in Q1

    The insurer is poised to see additional gains throughout the year as the special enrollment period for Healthcare.gov remains open and states are barred from removing Medicaid members from their rolls.

    By April 29, 2021
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    Humana
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    Humana snaps up remaining stake in home health giant Kindred for $5.7B

    The payer also reported first quarter revenue of $20.7 billion on profit of $828 million, up a whopping 75% year over year.

    By April 28, 2021
  • CMS pitches extra year of add-on payments for Boston Scientific, Stryker, other devices

    In light of the COVID-19 pandemic, the agency is proposing the payments to hospitals be extended beyond the typical timeframe for 14 products.

    By Nick Paul Taylor • April 28, 2021
  • Centene Plaza in St Louis
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    Retrieved from Paul Sableman on March 12, 2021
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    Centene Q1 performance fueled by lower medical usage, 1.3M new members

    Executives seemed optimistic about the remainder of the year, raising full-year guidance as they see momentum coming from Medicaid and Affordable Care Act marketplace growth due to the special enrollment period.

    By April 27, 2021
  • Molina acquires Cigna's Medicaid business in Texas for $60M

    The deal is set to boost Molina's existing footprint in the state as the managed care company continues to execute on its strategy of growth through bolt-on acquisitions.

    By April 23, 2021
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    Drew Angerer via Getty Images
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    ACA navigator funds get massive boost to record level

    The agency also said about 12 million people enrolled in an Affordable Care Act plan during the 2021 open enrollment period, a 5% increase from the year prior.

    By April 22, 2021
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    AdvaMed pushes CMS to implement MCIT final rule without further delay

    The Medicare agency postponed the proposal from taking effect amid criticism from some doctors and safety groups that it risks promoting device use without rigorous evidence of safety and effectiveness.

    By Susan Kelly • April 21, 2021
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    Getty / Edited by BioPharma Dive
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    Bluebird to withdraw gene therapy from Germany after dispute over price

    The biotech will cut staff, primarily in Europe, after negotiations with German health authorities resulted in a price lower than Bluebird had sought. 

    By Ned Pagliarulo • April 21, 2021
  • Anthem reports major Medicaid growth in Q1 as executives downplay concerns of pent-up care demands

    The payer reported a profit for the quarter driven by performance of its pharmacy benefit management arm and its government plans. It missed Street expectations on revenue, but beat on earnings and hiked EPS guidance.

    By April 21, 2021