Payer: Page 85
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Sponsored by Geneia LLC
How to use AI to reduce diabetes costs
Using AI to predict which type 2 diabetics will experience a diabetes-related complication can help payers save millions of dollars.
By Jasmine McCammon, Ph.D., Geneia Principal Data Scientist • Oct. 9, 2019 -
PPO? Co-pay? Cigna tries to explain health coverage to new members
"The ACA was really able to open the doors for a segment of the population that had really limited knowledge about how health insurance works," said Manish Naik, who leads the individual and family plans business for the payer.
By Samantha Liss • Oct. 8, 2019 -
Startup Devoted says it's 1st MA plan to offer Apple Watch
It's not the first time Apple has made a wearables deal with an insurer, but does represent the tech giant's first concrete foray into Medicare Advantage.
By Rebecca Pifer Parduhn • Oct. 8, 2019 -
Livongo scores biggest diabetes contract yet
Investors reacted to the news of the BCBS federal employee program agreement by bumping up Livongo's shares more than 18%.
By Nick Paul Taylor • Oct. 8, 2019 -
Trump signs executive order bolstering MA in pushback on 'Medicare for All'
The directive would let commercial Medicare plans offer more novel benefits and allow beneficiaries to join in on some of the savings payers are able to deliver through cash or rebates.
By Samantha Liss • Oct. 3, 2019 -
Walmart pilot will steer employees to local, high-quality docs
The country's largest private employer is trialing the program in Northwest Arkansas, Orlando and Tampa in Florida, and the Dallas-Fort Worth area.
By Rebecca Pifer Parduhn • Oct. 3, 2019 -
Ramping up rhetoric against 'Medicare for All,' Trump looks to bolster popular MA program
Though administration officials were light on details, they said an executive order the president will sign Thursday aims to expand access to healthcare providers and the latest therapies.
By Samantha Liss • Oct. 3, 2019 -
ACOs taking on risk performed better in Medicare program last year
Participants generated nearly $740 million in savings under the model, and most also earned quality improvement rewards.
By Shannon Muchmore • Oct. 2, 2019 -
Payers roll out 2020 MA plans with increased focus on social determinants
"Clearly, Medicare Advantage has the ability and the opportunity to innovate in ways that's just harder under fee-for-service," said Sean Creighton, managing director with Avalere.
By Shannon Muchmore • Oct. 2, 2019 -
'A radical experiment': Payers, providers renew attacks on price transparency proposal
Industry groups skewered the rule as "the wrong approach," "anticompetitive," "confusing" and "missing the mark."
By Rebecca Pifer Parduhn • Sept. 30, 2019 -
After California surprise billing law, fewer specialty services were out-of-network
The new report "strongly contradicts" the California Hospital Association's claims the law is destroying provider networks, a study author said.
By Shannon Muchmore • Sept. 27, 2019 -
UnitedHealthcare says more consumers are shopping around for healthcare
The payer's latest survey suggests larger numbers of Americans are comparing prices for healthcare and switching providers based on what they find. But the survey didn't delve into the many obstacles around finding accurate prices.
By Ron Shinkman • Sept. 26, 2019 -
Anthem scoops up Centene-WellCare divestitures
Anthem is expected to pick up nearly 300,000 new Medicaid members through the acquisitions, according to state enrollment data.
By Samantha Liss • Sept. 26, 2019 -
Walmart's Sam's Club teams with Humana in worker discount program
The pilot offering four bundled plans also involves on-demand primary care app 98point6.
By Rebecca Pifer Parduhn • Sept. 26, 2019 -
Worker health insurance costs surpass wage growth, survey finds
"This survey underscores for me why for most Americans the issue is affordability much more than it is expanding coverage. And it really is just math," Kaiser Family Foundation CEO Drew Altman said of the results.
By Linda Wilson • Sept. 26, 2019 -
Verma touts MA premium drop, chastises payers for complacency
"Consumers are frustrated and fed up. And to address the elephant in the room, they are frustrated with you," the CMS administrator said, pointing to surprise billing, denying care and the complexity of the system.
By Samantha Liss • Sept. 25, 2019 -
States pull back curtain on drug prices, to uncertain effect
A newly enacted law in Colorado requires pharma companies inform doctors of drug list prices, as well as the names of three generics in the same treatment class.
By Ned Pagliarulo • Sept. 25, 2019 -
Air Methods in talks to contract directly with large employers
One of the nation's largest air ambulance operators told Healthcare Dive the move comes amid challenges getting Cigna, UnitedHealth and Aetna to sign contracts.
By Samantha Liss • Sept. 25, 2019 -
Pelosi lieutenant to payers: Help us defeat Big Pharma
His words sparked a clash between policy experts and industry representatives who spoke Monday during a panel at America's Health Insurance Plans' annual conference on Medicare and Medicaid.
By Samantha Liss • Sept. 24, 2019 -
Kaiser strike called off as company, unions reach tentative agreement
Arlene Peasnall, Kaiser's interim chief human resources officer, said the company and its workforce "may disagree at times, but we have always been able to work through our challenges to align on common goals."
By Rebecca Pifer Parduhn • Updated Sept. 25, 2019 -
Judge dismisses Oscar antitrust lawsuit against Florida BCBS
Florida Blue's contract requiring brokers to sell insurance only for Florida Blue or risk losing access to all of its product lines is lawful, the federal judge wrote in his opinion.
By Rebecca Pifer Parduhn • Sept. 23, 2019 -
Medicare Advantage plans see barriers to non-medical benefits
CMS allowed MA insurers to offer such benefits this year, but deployment was hampered by lack of new funding, according to a report from the Urban Institute and the Robert Wood Johnson Foundation.
By Ron Shinkman • Sept. 19, 2019 -
House Democrats forge ahead with direct Medicare drug price negotiation
While drug price constraints may still become law, House Speaker Nancy Pelosi's proposal looks like a long shot.
By Jonathan Gardner • Sept. 19, 2019 -
Tennessee unveils plan to change Medicaid funding to block grant program
The state would be the first to switch to the alternative funding mechanism if approved by federal regulators.
By Samantha Liss • Sept. 18, 2019 -
CMS mandatory radiation oncology model should be scaled back, industry argues
The model would examine effectiveness of site-neutral episode-based payments for treatment of 17 cancer types to radiotherapy providers and suppliers in randomly selected geographic areas.
Sept. 18, 2019
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