Health insurance coverage linked to reduced mortality

In a sweeping study of millions of households, researchers found that people were more likely to sign up for health insurance once prodded.

By Samantha Liss • Dec. 10, 2019

Surprise billing ban draft: Middle ground leaves few pleased

The bill backed by a bipartisan group of Senate and House leadership would require insurers pay at least the median in-network negotiated rate for the area market for out-of-network services and has an arbitration backstop.

By Shannon Muchmore • Dec. 10, 2019

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

Competing House surprise billing plan muddies path of White House-backed legislation

The House Ways and Means Committee unveiled its own surprise billing legislation Wednesday that relies on arbitration.

By Shannon Muchmore • Updated Dec. 12, 2019

UnitedHealth to acquire embattled specialty pharmacy Diplomat for $300M

Four separate lawsuits are attempting to enjoin the purchase, the payer said this week. The cases allege information about the deal was held back from Diplomat shareholders, including financial data.

By Rebecca Pifer • Updated Jan. 24, 2020

Payer of the Year: Centene

Centene's blockbuster acquisition of WellCare doubled its Medicare Advantage footprint and positions the company to be the leader of government-sponsored plans.

By Samantha Liss • Dec. 9, 2019

Executive of the Year: Larry Merlo, CVS Health

Merlo has a vision for the future of the industry, and he's leveraging all of the retail giant's many assets to try and get there.​

By Rebecca Pifer • Dec. 9, 2019

The Healthcare Dive Awards for 2019

From the Affordable Care Act lawsuit to CVS Health CEO Larry Merlo, these are the companies, executives and movements that shaped U.S. healthcare this year.

Dec. 9, 2019

Value-based care payments increasing but risk still rare

Bundled payment adoption, for example, remained flat between 2012 and 2017 despite studies showing their promise in holding down costs, the Catalyst for Payment Reform found.

By Ron Shinkman • Dec. 6, 2019

More than 1K employers push Senate to repeal ACA Cadillac tax

AHIP and the U.S. Chamber of Commerce were among those arguing the tax will have sweeping effects beyond just "gold-plated" health coverage and will raise costs for the millions of Americans with employer coverage.

By Rebecca Pifer • Dec. 6, 2019

US healthcare spending growth rebounded last year, influenced by insurance tax

Hospital and physician and clinical services spending fell, but prices were up. CMS Administrator Seema Verma blamed provider consolidation and the "creation of monopolies."

By Shannon Muchmore • Dec. 5, 2019

Medicare Advantage members rarely review or switch plans

A Kaiser Family Foundation analysis found that more than one in three Medicare beneficiaries reported difficulty comparing plan options and nearly half of those on Medicare said they rarely or never review their choices.

By Shannon Muchmore • Dec. 4, 2019

Will sky-high drug prices spur the US to use an obscure power over patents?

New cell therapies as well as gene-based treatments like Zolgensma benefited from NIH funding of early-stage research. Advocates say the time is now for the government to invoke its "march-in" rights. 

By Jonathan Gardner • Dec. 4, 2019

Senators push CMS, commercial payers on bias in algorithms

The letters sent to UnitedHealth, Blue Cross Blue Shield, Cigna, Humana and Aetna flagged a study that found racial bias in a widely used algorithm for assessing healthcare needs.

By Susan Kelly • Dec. 4, 2019

Hospitals sue HHS, warning price transparency rule would chill competition, crash computers

An agency spokeswoman shot back that hospitals "should be ashamed that they aren't willing to provide American patients the cost of a service before they purchase it."

By Samantha Liss • Dec. 4, 2019

Anthem, Passport to protest $7B Kentucky Medicaid contract loss

Aetna, Humana, Molina, UnitedHealthcare and WellCare were the winners in the bid to provide coverage to about 1.3 million Medicaid members.

By Samantha Liss • Dec. 3, 2019

Centene sells Illinois plans to CVS in next step for WellCare buy

Centene has already divested its Medicaid managed care business in Nebraska and Missouri as it nears completion of the $17 billion acquisition of its rival.

By Samantha Liss • Dec. 2, 2019

Global Blood's sickle cell drug wins FDA approval, joining Novartis' Adakveo

A list price of roughly $10,000 a month puts Global Blood's Oxbryta slightly higher than what Novartis' Adakveo will cost.

By Jonathan Gardner • Nov. 26, 2019

Walgreens, UnitedHealthcare team up to open in-store Medicare centers

The move comes as rival retailers like CVS and Walmart devote more floor space to health services. The 14 stores will open next year in five metro areas.

By Samantha Liss • Nov. 26, 2019

Standards body urged to add device identifiers to insurance claims forms

Advocates say such a policy change would improve patient safety and save the healthcare system money by allowing better tracking of implants by brand and model.

By Susan Kelly • Nov. 26, 2019

Mandatory CMS radiation oncology model goes on backburner

Originally, the agency was eyeing an implementation date as early as Jan. 1, but the new regulatory agenda lists July 2022 as a target date for the bundled payment model.

By David Lim • Nov. 26, 2019

Myth Diagnosis: Is healthcare recession-proof?

"That's a little bit of a misnomer," Ben Isgur, health researcher at PwC, told Healthcare Dive. "It is a little recession-resistant, but eventually that wears off."

By Shannon Muchmore • Nov. 22, 2019

Hospital market power shares blame for mushrooming middle-class health costs, Commonwealth Fund says

"There is very little restraint on pricing," the research group's president David Blumenthal said. Hospitals are motivated to boost prices to offset declining rates of inpatient utilization, particularly if they have excess capacity, he added.

By Linda Wilson • Nov. 21, 2019

Providers take next step in social determinants: hyperlocalism

Industry can "help others have an uncomfortable dialogue about what is truly driving health outcomes in this country," Atrium Health's Alisahah Cole said at the Healthcare of Tomorrow conference.

By Shannon Muchmore • Nov. 19, 2019

Hospitals pledge to fight Trump admin price transparency plan in court

President Donald Trump said patients have "been getting ripped off for years" and HHS Secretary Alex Azar said the requirements are a "revolutionary" change for the industry.

By Samantha Liss , Shannon Muchmore • Nov. 18, 2019

Hospitals — and now insurers — to reveal secret rates under latest Trump admin pitch

Industry lobbies have argued the government lacks authority to issue such mandates and are sure to fight back against what would be a landmark shift in healthcare.

By Samantha Liss • Nov. 15, 2019