Payer: Page 66
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Alex Wong via Getty Images
CMS expands Medicare emergency telehealth coverage with 11 new services
The agency also said more than 36% of those in traditional Medicare used a virtual visit between March and August and usage among Medicaid members has skyrocketed.
By Rebecca Pifer • Oct. 15, 2020 -
UnitedHealth says Q3 volume rebounds, net income down on consumer price breaks
Still, the first payer to report quarterly earnings bested Wall Street expectations and saw a lower-than-expected medical cost ratio of 81.9% for the third quarter.
By Samantha Liss • Oct. 14, 2020 -
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 -
Payer competition shrinks in already scarce markets, AMA survey finds
The five insurers with the biggest share in the most markets were Anthem, Health Care Service Corp., UnitedHealth Group, Florida Blue and Highmark.
By Hailey Mensik • Updated Oct. 15, 2020 -
Brian Tucker/Healthcare Dive
Teladoc-Livongo make first combined sale to Guidewell Health
The Florida Blue plan, which has been a Teladoc client for several years, will now offer Livongo's diabetes platform to some 50,000 members. Executives claimed more interest behind the scenes Monday at HLTH.
By Rebecca Pifer • Oct. 13, 2020 -
Medicare coronavirus vaccine pay rule predicted by month's end, Verma says: HLTH 2020
It's unclear whether CMS has the regulatory power to reimburse for a vaccine if approved by the FDA under an emergency use authorization, as public health officials expect. The rule will likely tackle that.
By Rebecca Pifer • Oct. 13, 2020 -
Employer healthcare costs stable in 2020, COVID-19 impact still unclear, KFF says
Still, despite modest premium growth, the annual Kaiser Family Foundation Employer Health Benefits survey notes costs for family coverage rose double the rate of inflation over the past five years.
By Ron Shinkman • Oct. 8, 2020 -
Medicare Advantage enrollees in 4-star or higher plans to drop in 2021
Cigna appears a winner as about 88% of its members will be in plans with four or more stars. Hitting higher scores gives plans the chance to nab lucrative bonuses.
By Samantha Liss • Oct. 8, 2020 -
Most employers won't turn to healthcare cost shifting in 2021, Mercer says
Months into a public health crisis, the outlook for employer-sponsored healthcare could shift significantly due to deferred care.
By Ryan Golden • Oct. 8, 2020 -
Walmart enters Medicare broker market, threatening incumbents
The massive retailer plans to sell MA, supplement and prescription drug plans from major insurers like UnitedHealthcare and Humana during this year's annual enrollment period.
By Rebecca Pifer • Oct. 7, 2020 -
Courtesy of Target
More than 14M may have lost health coverage after historic job losses, study finds
Not all lost jobs result in a loss of coverage, so researchers have been keen to figure out how historic unemployment has ultimately affected insurance status.
By Samantha Liss • Oct. 7, 2020 -
MA startup Clover Health goes public in blank check deal valuing it at $3.7B
The transaction expected to close in early 2021 is the latest in a string of IPOs and deals for digital-focused healthcare companies.
By Rebecca Pifer • Oct. 6, 2020 -
Medicare advisers toy with MA payment overhaul as major payers expand for 2021
MedPAC commissioners floated a new methodology in the Medicare Advantage program blending local and national spending, but pushback from payers is likely if the change is finalized.
By Rebecca Pifer • Oct. 5, 2020 -
UnitedHealth, Cigna to expand Medicare Advantage footprints, touting telehealth for 2021
Humana, Anthem and Aetna are also moving into new geographies with the popular and lucrative program. In addition, smaller player Clover Health is partnering with Walmart to offer plans in Georgia.
By Shannon Muchmore • Oct. 2, 2020 -
[Photograph]. Retrieved from Regional Health Command Atlantic.
Patients give high marks to telehealth, J.D. Power says
The survey of more than 4,300 people ranked Amwell and Doctor on Demand as well as insurers. Sicker patients were less likely to report a positive experience.
By Ron Shinkman • Oct. 1, 2020 -
Photography by Adam Schultz/Photo edit by Kendall Davis/Healthcare Dive
Deep DiveElection 2020: Trump and Biden's starkly diverging views on healthcare
Spoiler: the two nominees diverge on almost everything.
By Rebecca Pifer • Oct. 1, 2020 -
4M added to Medicaid rolls due to coronavirus pandemic
The job market — which many rely on for commercial insurance coverage — is likely to remain strained as long as the U.S. fails to contain the spread of the novel coronavirus. The resulting shift in payer mix is unfavorable for providers.
By Samantha Liss • Oct. 1, 2020 -
$6B fraud bust includes numerous telehealth schemes
Providers quickly pivoted many services to virtual care during the COVID-19 pandemic, potentially inviting fraud.
By Shannon Muchmore • Oct. 1, 2020 -
Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law
The law signed by the president Thursday is likely the only direct aid providers can expect before the November presidential election, after Congress deadlocked on further COVID-19 legislation.
By Rebecca Pifer • Oct. 1, 2020 -
Rangel, David. [photograph]. Retrieved from https://unsplash.com/photos/4m7gmLNr3M0.
Anthem to pay almost $40M to settle 2015 cyberattack investigation
The settlement ends a long-standing investigation into the payer following a series of targeted hacks that exposed the health information of almost 79 million people. Anthem continues to deny any wrongdoing.
By Hailey Mensik • Sept. 30, 2020 -
Provider finance execs bracing for unfavorable shift in payer mix, survey finds
About 70% of CFOs and revenue cycle leaders are readying for a drop in commercially insured patients — a highly prized cohort for providers and health systems.
By Samantha Liss • Sept. 30, 2020 -
Molina's $380M buy vastly boosts managed care footprint in New York
The acquisition of Affinity Health Plan will add 284,000 Medicaid members, a significant increase as the payer climbs the ranks in a state currently dominated by rival Centene.
By Shannon Muchmore • Sept. 29, 2020 -
CMS touts dip in Medicare Advantage premiums for 2021
SVB Leerink analysts point to Centene, Humana and UnitedHealthcare as payers best positioned to pick up more share next year.
By Samantha Liss • Sept. 25, 2020 -
Getty Images
Sponsored by GeneiaIt's high time payers opened the digital front door
A digital front door helps health plans to improve member satisfaction, quality outcomes and costs.
By Heather Staples Lavoie, President and CEO, Geneia • Sept. 25, 2020 -
Opinion
Medicare Advantage should not 'game the system' but prioritize patient care, honest billing
The HHS Office of Inspector General's principal deputy warns, "My office and other government agencies are targeting oversight to make sure plans do not pad risk adjustments with unsupported diagnoses."
By Christi A. Grimm • Sept. 23, 2020 -
Payers, other stakeholders urge Congress to blunt COVID-19-spurred insurance losses
"The odds are we are on track to having the greatest coverage losses we've ever recorded," Stan Dorn, director of the National Center for Coverage Innovation and senior fellow at Families USA, said during a briefing Tuesday.
By Samantha Liss • Sept. 23, 2020
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