Payer: Page 81
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Payer stocks rebound as Super Tuesday results quell M4A fears
A slew of primary wins by former Vice President Joe Biden helped tamp down fears that managed care companies could be downsized or eliminated under "Medicare for All" pushed by Sen. Bernie Sanders.
By Rebecca Pifer Parduhn • March 4, 2020 -
JAMA finds public insurance payments increased more than private
Lower back and neck pain and other musculoskeletal disorders accounted for the highest amount of spending in 2016 at an estimated $134.5 billion — 57.2% of which was paid for by private insurance, according to the research.
By Hailey Mensik • March 3, 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 -
UnitedHealthcare-Mednax fallout set to hit Raleigh area
Even though North Carolina has some consumer protections when it comes to surprise billing, it will not be enough to shield all patients if and when surprise bills from the pricing squabble arise.
By Samantha Liss • Feb. 27, 2020 -
Short-term insurance challenger warns plans are a 'threat to public health'
"At the risk of using jargon, this is crazy town bananapants," Association for Community Affiliated Plans CEO Margaret Murray said.
By Hailey Mensik • Feb. 27, 2020 -
Samantha Liss/Healthcare Dive
Corporate watchdog pegs Centene, CVS CEOs as among most overpaid
With healthcare costs rising faster than inflation, industry executives are ripe targets for criticism over compensation. The payer defended the figure and said it's based on industry standards.
By Rebecca Pifer Parduhn • Feb. 26, 2020 -
Getty / Edited by Healthcare Dive
Tenet closes out 2019 at $243M loss
Volume growth in the fourth quarter was a bright spot for the for-profit hospital operator. Tenet has now reported hospital adjusted admissions gains for four consecutive quarters.
By Rebecca Pifer Parduhn • Feb. 25, 2020 -
In a nod toward pharma, ICER makes deal to access real-world evidence
A partnership with Aetion will give ICER more information to include in its drug reviews, but could renew debate on the usefulness of evidence collected outside of clinical study.
By Jonathan Gardner • Feb. 24, 2020 -
CMS pitches expanding bundled payments for joint replacements
One Wall Street analyst suggested that post-acute care providers, not the manufacturers of pricey medical devices used in surgeries, face the greatest financial risks.
By Ron Shinkman • Feb. 21, 2020 -
ACOs ask CMMI for more shared savings in direct contracting model
The group asked for more details on the financial methodology to be released immediately, saying members "are finding the lack of information a tremendous hindrance to participation."
By Shannon Muchmore • Feb. 21, 2020 -
UnitedHealthcare terminates Mednax from its network over pricing squabble
The dispute puts patients, particularly those undergoing surgery, women with high-risk pregnancies and ill newborns, at risk of out-of-network bills in four states: Arkansas, Georgia, North Carolina and South Carolina.
By Samantha Liss • Feb. 21, 2020 -
Choice grows in ACA exchanges, report finds, as Supreme Court mulls effort to kill law
A new McKinsey & Company analysis comes as the high court convenes Friday to decide whether to review the Republican lawsuit seeking to overturn the landmark law.
By Rebecca Pifer Parduhn • Feb. 21, 2020 -
Deep Dive
Frustrated employers buck status quo, leave insurers for riskier arrangements
"In a nutshell, has it been an easy two to three years? No. But it has to be the way we go because healthcare costs are just going absolutely stupid," the owner of a North Carolina auto group said of the transition.
By Samantha Liss • Feb. 20, 2020 -
Senseonics' implantable CGM wins Cigna coverage, shares soar
CEO Tim Goodnow late last year identified Cigna, along with Anthem and UnitedHealthcare, as key commercial payers to win over.
By Nick Paul Taylor • Feb. 19, 2020 -
Price hikes drove employer-sponsored health costs to record high in 2018
The Health Care Cost Institute, drawing on data from Aetna, Humana, Kaiser Permanente and United Healthcare, found higher prices accounted for about three-quarters of the increase, while usage rose just about 3%.
By Hailey Mensik • Feb. 14, 2020 -
3 surprise billing proposals compared side by side
Congress advanced two proposals last week to ease unexpected medical bills as pressure mounts from consumers. Here are the key elements under consideration.
By Samantha Liss , Shannon Muchmore • Feb. 13, 2020 -
CVS swings to $6.6B profit in 2019, buoyed by Aetna
The payer also saw growth in government services, reporting its Medicare Advantage business grew over three times the industry average in 2019, CEO Larry Merlo said Wednesday.
By Rebecca Pifer Parduhn • Feb. 12, 2020 -
Payers saw medical cost ratios rise in Q4
As the country's major health insurers finished reporting their financial results from the fourth quarter of 2019 this week, a few themes emerged.
By Samantha Liss • Feb. 12, 2020 -
As SDOH efforts take off, payers try to carve out their role
Signify Community's Jamo Rubin said at a conference this week, "in four years of medical school and then residency, I never learned one thing about what happens to people after they get discharged."
By Rebecca Pifer Parduhn • Feb. 12, 2020 -
Molina posts mixed Q4, says ACA shoppers not switching for savings
In an effort to drive greater membership in the marketplaces this year, the payer cut prices by 4% on average. But that didn't spur the growth hoped for in 2020, particularly in Texas and Florida.
By Samantha Liss • Feb. 11, 2020 -
1 in 5 surgery patients hit with surprise medical bill, JAMA study finds
Anesthesiologist and surgical assistants were associated with the most out-of-network charges. The findings come as lawmakers in Congress debate rival proposals to curb the unexpected bills this week.
By Hailey Mensik • Feb. 11, 2020 -
Kaiser income nearly triples to $7.4B in 2019, driven by investments
The results come as nonprofit healthcare operators across the country face rising scrutiny from regulators and lawmakers for what critics call excessive profits for a tax-exempt entity.
By Samantha Liss • Feb. 10, 2020 -
Q&A
One Medical's CFO on why primary care is ripe for disruption
The company's IPO was for 17.5 million shares at $14, the low end of its range. On the listing day Jan. 31, shares jumped to about $20. Since then, the stock price has continued to rise.
By Shannon Muchmore • Feb. 7, 2020 -
Azar touts 2019 greatest hits, glosses over setbacks in state of HHS speech
He skated over some high-profile efforts from the Trump administration that didn't bear fruit or sparked bad publicity last year, such as efforts to lower drug prices, Medicaid work requirements and cutting away at the ACA.
By Rebecca Pifer Parduhn • Feb. 7, 2020 -
Rival surprise billing efforts jockey for attention in election year
Two new pieces of draft legislation, one from the House Ways and Means committee and another from the Education and Labor panel, were introduced Friday as Congress struggles to make headway on the issue.
By Rebecca Pifer Parduhn • Updated Feb. 10, 2020 -
CMS proposes changes to Part D drug tiers, real-time benefit info for seniors
The proposed rule would also allow patients with end-stage renal disease to enroll in MA plans starting in 2021. Payer groups, however, voiced concerns about the change.
By Samantha Liss • Feb. 6, 2020
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