ACA slashed uninsured rate, but number who can't afford care still rising

Between 1998 and 2017, the proportion of the U.S. population unable to see a doctor due to the associated costs of doing so rose from 11.4% to 15.7%, according to a new JAMA Internal Medicine study.

By Ron Shinkman • Jan. 26, 2020

Blue Cross Blue Shield partners with Civica on generic drug mission

The Blue Cross Blue Shield Association, along with 18 affiliate companies, will invest $55 million to create a new unit of the generic drug company.

By Kristin Jensen • Jan. 23, 2020

Explore the Trendline➔

Payer/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

New conservative faction to lobby against benchmark surprise billing fix

The argument against a benchmark rate is popular among provider lobbies, which have spent millions to oppose such proposals — including White House-backed legislation from Senate and House heavyweights.

By Rebecca Pifer • Jan. 22, 2020

Centene closes $17B acquisition of WellCare

The companies said Thursday morning the deal was complete and WellCare common stock would cease trading at the end of the day.

By Shannon Muchmore • Updated Jan. 23, 2020

UnitedHealth, Humana among Medicaid contracts nixed in Louisiana after protest

The decision came in response to appeals filed by Centene and Aetna, which were denied new contracts. The state will now redo the bidding process.

By Hailey Mensik • Jan. 22, 2020

Tenet, CVS and Cigna lead Healthcare Dive's JPM20 coverage

Molina and Centene also touted their organic growth potential at the annual investor conference drawing some of the biggest industry names.

Jan. 17, 2020

FTC commissioner pledges hard line on hospital mergers

Lobbyists and legislators also spoke at a Council for Affordable Health Coverage forum, noting a surprise billing ban is still on the table for Congress despite disagreements over the policy to achieve it.

By Shannon Muchmore • Jan. 17, 2020

Key 2020 trends for payers and providers

No matter who wins the White House come November, healthcare experts say the push to reimburse providers for value and the aim for greater transparency surrounding prices will keep moving ahead.

By Samantha Liss • Jan. 17, 2020

MedPAC finds 340B effect on pricing 'modest,' going against pharma critique

The commission's report provides some new ammunition in the ongoing battle between pharmaceutical companies and nonprofit disproportionate share hospitals over the future of the 340B drug discount program.

By Rebecca Pifer • Jan. 17, 2020

CVS, Cigna execs tell JPM20 they're ready for a contentious election year

The payer officials took to the stage at the annual investor conference in San Francisco, speaking on the future of M&A and reflecting on what's sure to be a year focused on policy and politics.

By Rebecca Pifer , Shannon Muchmore • Jan. 15, 2020

Hospitals, insurers urge Supreme Court to hear ACA case to avert havoc

Lobbying groups said the case could take years to play out without the high court stepping in to hear arguments now.

By Samantha Liss • Jan. 15, 2020

UnitedHealth reports nearly $14B in 2019 profit

The company beat forecasts on Q4 earnings, though revenues of $60.9 billion were slightly lower than Wall Street expectations.

By Rebecca Pifer • Jan. 15, 2020

LabCorp, Quest push for M&A-driven growth despite difficulties closing deals

"It’s still a very fragmented marketplace. There’s plenty of opportunity for us to consolidate it," Quest CEO Steve Rusckowski said.

By Nick Paul Taylor • Jan. 15, 2020

Will more employers get off the healthcare bench in 2020?

"At the end of the day, employers have to put their hands on the steering wheel as purchasers of healthcare," Suzanne Delbanco, executive director of Catalyst for Payment Reform, said.

By Rebecca Pifer • Jan. 14, 2020

Cigna links up with upstart Oscar for small business health insurance

New York City-based Oscar has won some praise for customer service, but also criticism for small provider networks.

By Rebecca Pifer • Jan. 14, 2020

JPM20: Rivals Molina, Centene pitch investors on organic growth

"I'll repeat this countless numbers of times this afternoon: Our first priority is to grow the business organically. It is the most efficient use of capital," Molina CEO Joseph Zubretsky said as the annual investor conference kicked off.

By Samantha Liss • Jan. 14, 2020

Supreme Court to take on PBM rate regulation

A federal appeals court previously ruled in favor of pharmacy benefit managers, finding federal law preempts states from regulating their rates.

By Samantha Liss • Jan. 13, 2020

The government recovered $3B in fraud last year. Nearly 90% was from healthcare

It marks the 10th consecutive year the DOJ has recouped more than $2 billion from False Claims Act settlements and judgments for HHS.

By Rebecca Pifer • Jan. 10, 2020

CVS, Mayo, Tenet among healthcare companies to watch at #JPM20

As many as 9,000 attendees across 450 public and private companies are expected to make an appearance in San Francisco at one of the most influential conferences of the year.

By Samantha Liss , Shannon Muchmore , Rebecca Pifer • Jan. 10, 2020

Individual market appears stable despite lack of mandate penalty

Claims costs in the first nine months of 2019 grew and average hospital time dipped, indicating the market didn't have disproportionately sicker patients, according to the Kaiser Family Foundation.

By Shannon Muchmore • Jan. 8, 2020

Molina expands Illinois footprint with $50M acquisition

The buy of NextLevel Health Partners, if approved, would give Molina more members in Cook County.

By Samantha Liss • Jan. 8, 2020

DOJ joins whistleblower suit against Indiana system for alleged Stark violation

Community Health Network is accused of submitting as many as hundreds of thousands of fraudulent claims to Medicare and other federal programs from at least 2008 to 2017.

By Rebecca Pifer • Jan. 8, 2020

CMS proposes using more encounter data for MA risk adjustment

The mix of encounter data used to calculate payments would go up to 75% next year under the proposed regulation. Payers have railed against previous increases, saying the information is inaccurate and unreliable.

By Shannon Muchmore • Jan. 7, 2020

Ex-Anthem exec Brad Smith appointed head of CMS innovation center

Smith, previously co-founder and CEO of palliative care company Aspire Health, replaces outgoing CMMI head Adam Boehler.

By Rebecca Pifer • Jan. 7, 2020

Supreme Court says ACA opponents have until Friday to respond to motion to expedite

The court set the deadline Monday after a push by the law's supporters to have the case heard before this year's presidential election.

By Samantha Liss • Updated Jan. 7, 2020