Cigna touts 2019 medical cost trend

CEO David Cordani defended the company's strategy to pursue partnerships with other players such as Prime Therapeutics and Oscar. "It's a dynamic marketplace and those who create the most value will win," he said.

By Samantha Liss • Feb. 6, 2020

Humana eyes doubling primary care membership, reports MA boost in Q4

Building off a new joint venture between a subsidiary and private equity firm, the payer said its primary care clinics still cover a "relatively small portion" of the overall Medicare Advantage business.

By Shannon Muchmore • Feb. 5, 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

January price increases confirm slowing drug inflation

Payer and public pressure has led to slowing hikes, but more products are subject to increases, analysts say.

By Jonathan Gardner • Feb. 5, 2020

Lawmakers push for more oversight at CMS innovation center

A bipartisan group in the House introduced a bill that would require HHS to track how demonstration models impact patient access to care and potentially overhaul or eliminate those found to have adverse effects.

By Hailey Mensik • Feb. 5, 2020

Flu dampens Centene's Q4 medical loss ratio

CEO Michael Neidorff also weighed in on the Trump administration's proposal to partially reshape the Medicaid program into a block grant system, calling it a potential net positive for payers.

By Samantha Liss • Feb. 4, 2020

Humana expanding primary care centers through joint venture with PE firm

The payer and Welsh, Carson, Anderson & Stowe, which will have majority ownership, are making an initial commitment of about $600 million.

By Shannon Muchmore • Feb. 3, 2020

Payers, employers protest price transparency rule as wrong-headed

Most of the 23,355 public comments expressed skepticism or all-out opposition to the Trump administration's proposal targeting insurers.

By Samantha Liss • Jan. 31, 2020

The Trump administration is offering Medicaid block grants. Which states will say yes?

So far, the governors of Oklahoma and Arkansas have both expressed explicit support for the guidance allowing states to cap payments for adults who became eligible for Medicaid under the 2010 ACA expansion.

By Rebecca Pifer Parduhn • Jan. 30, 2020

Codes for social determinants rarely used, analysis finds

The most frequently used code was for homelessness, followed by problems related to living alone and disappearance and death of a family member, according to CMS.

By Shannon Muchmore • Jan. 30, 2020

Trump admin to allow Medicaid caps, but legal fight likely as providers protest

Providers were quick to attack the highly anticipated plan giving states the option of accepting block grants for payment in the safety-net program, choosing between a per-enrollee or total coverage budget.

By Rebecca Pifer Parduhn • Updated Jan. 30, 2020

Anthem beats earnings estimates but MLR disappoints

Operating revenue for the payer last year grew nearly 13% year over year to just above $103 billion. For the fourth quarter, it was up 16.4% to $27.1 billion, slightly above Wall Street expectations.

By Shannon Muchmore • Jan. 29, 2020

CMS widens NGS test coverage for inherited breast, ovarian cancers

While the agency declined to expand coverage beyond breast and ovarian, local Medicare contractors can make coverage determinations with other germline cancer diagnoses and on tests that have not been OK'd by FDA.

By Maria Rachal • Jan. 29, 2020

Pfizer poised to launch 3 biosimilars in coming months

The big pharma company, which has criticized others for stifling the U.S. biosimilars market, could have three cancer copycats on the market in the next three months.

By Jacob Bell • Jan. 29, 2020

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

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 Parduhn • 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 Parduhn • 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 Parduhn , 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 Parduhn • Jan. 15, 2020