Coronavirus could hike premiums by double digits next year

Payers, smack dab in the middle of rate-setting for 2021, could increase premiums from 4% to more than 40% if they aim to recoup all COVID-19 costs and protect solvency, California actuaries say.

By Rebecca Pifer Parduhn • March 25, 2020

As Congress gains ground on stimulus, healthcare workers ask people to stay home

President Donald Trump, however, said he wanted the nation to be "opened up" by Easter, despite strong advice from public health experts that the U.S. continue social distancing efforts.

By Shannon Muchmore • March 25, 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

Nearly 2 dozen states now have Medicaid waivers for coronavirus response

The waivers allow suspension of federal regulations surrounding prior authorization, sites of care and physician enrollment, among others.

By Rebecca Pifer Parduhn • Updated March 26, 2020

A guide to clinical trials disrupted by the coronavirus pandemic

KalVista Pharmaceuticals is the latest company to update its plans, but earnings disclosures this month could bring news of widening impact to studies. 

By Nami Sumida • Updated March 31, 2020

On 10th anniversary, embattled Affordable Care Act faces yet another stress test

The law now faces a significant test as the nation likely heads into a recession amid the novel coronavirus pandemic, straining the health system in an unprecedented way.

March 23, 2020

Hard-hit Washington state gets CMS green light for Medicaid coronavirus waiver

The Trump administration did not approve a request to expand Medicaid to a greater number of uninsured residents in the state.

By Rebecca Pifer Parduhn • March 20, 2020

Telehealth payment parity in Medicare welcome, but some vendors say it should have come sooner

"We've all been preparing for this and we certainly anticipated this was going to happen," Doctor on Demand's chief legal and business affairs officer told Healthcare Dive.

By Rebecca Pifer Parduhn • March 19, 2020

Value-based payment models take hold in medtech, but barriers slow shift

The arrangements are becoming more prevalent, especially for costly devices used in chronic disease management and in hospital settings, according to a recent Deloitte report.

By Susan Kelly • March 18, 2020

Medicare will now cover telehealth to fight coronavirus

It's a move telemedicine companies like Teladoc and American Well have been requesting since well before the outbreak, but the change is scheduled to be in place only for as long as the national emergency is designated.

By Rebecca Pifer Parduhn • March 17, 2020

Trump administration approves 1st Medicaid waiver to combat coronavirus

Florida was the first state to submit a section 1135 waiver in response to the national emergency, but it's unlikely to be the last as the country grapples with its response to the virus.

By Rebecca Pifer Parduhn • March 17, 2020

COVID-19 puts unprecedented strain on US health system

Some Providence hospitals are converting operating rooms to intensive care units to prepare for a surge in coronavirus patients as federal officials pleaded with the American public to avoid gathering in groups.

March 17, 2020

As coronavirus threatens hospital capacity, debate swirls around elective procedures

The Senate is expected this week to take up a House-passed relief package that includes a 6.2 percentage point hike to the federal Medicaid matching rate, a move backed by providers.

By Shannon Muchmore • March 16, 2020

MedPAC suggests targeted increase in hospital rates

The commission's annual March report to Congress also showed Medicare Advantage enrollment continues to increase, with a 10% jump from 2018 to 2019.

By Shannon Muchmore • March 13, 2020

As US officials shift tone, Trump stops short of 1 provider ask

The president addressed the nation Wednesday night but did not declare a disaster or national emergency, which groups like the American Hospital Association had sought.

By Samantha Liss , Shannon Muchmore • March 12, 2020

Controversial EHR mandate in interoperability rule could threaten hospital Medicare reimbursement

The new requirement that hospitals must send electronic notice of key changes in a patient's status is worrying some facilities, especially those in rural areas and treating a high proportion of low-income patients.

By Rebecca Pifer Parduhn • March 12, 2020

CMS launches payment model designed to lower out-of-pocket insulin costs

The new program for Medicare Part D plans would cap insulin copays at $35. Some commercial payers have already made similar moves to lower insulin costs, such as Cigna and Express Scripts.

By Hailey Mensik • March 12, 2020

CVS adds 5 digital health programs for PBM clients

Livongo Health, Hinge Health, Hello Heart, Torchlight and Whil are now available for clients to use, in addition to Sleepio, a personalized digital sleep program and the first participating program when the service launched in 2019.

By Rebecca Pifer Parduhn • March 12, 2020

UnitedHealth likely to keep squeezing physician staffing firms

Since the insurer's 2018 tussle with ER staffing firm Envision, "it's sort of ramped up and become more aggressive and more abrupt and more pervasive," one analyst said.

By Samantha Liss • March 11, 2020

CMS eases more Medicare restrictions to boost coronavirus treatment access

The actions won't necessarily remove cost barriers for patients. Most payers have not extended the coverage promises to employers' self-insured plans that cover the majority of Americans, and high deductibles persist.

By Shannon Muchmore • March 11, 2020

California accuses healthcare sharing ministry of misleading consumers

States are increasingly cracking down on alternative insurance from healthcare sharing ministries, which aren't required to pay out claims and don't have to cover basic health benefits.

By Rebecca Pifer Parduhn • March 11, 2020

Hospitals dipping into emergency stocks to combat coronavirus

While more community spread of COVID-19 is reported daily, hospitals are bracing for a rush of patients and payers are waiving fees for telemedicine consults and extra prescription drug supplies.

By Shannon Muchmore • March 10, 2020

LabCorp launches coronavirus test, Quest in the wings

The updates from America's mega-clinical labs come days after FDA OK'd the use of lab developed tests that have not yet received emergency use authorization.

By Maria Rachal • March 5, 2020

Insurer lobby urges coronavirus test coverage, but can't mandate changes

"They can’t require member companies to do anything," Sabrina Corlette, a research professor at Georgetown University, told Healthcare Dive. 

By Samantha Liss • Updated March 6, 2020

Humana program to reimburse providers for identifying social determinants like homelessness, food insecurity

The first provider to participate is Ochsner Health, Louisiana's largest non-profit academic healthcare system.

By Hailey Mensik • March 5, 2020

New estimate puts cost to develop a new drug at $1B, adding to long-running debate

Pharma companies spend $300 million to $400 million bringing a new medicine to market, but per-product R&D costs are much higher after accounting for the many drugs that fail in testing. 

By Jonathan Gardner • March 4, 2020