Payer: Page 86
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UnitedHealth's acquisition of DaVita physician group gets FTC approval
Under an agreement reached with the federal agency, the payer will divest the medical group's Las Vegas practice to Intermountain Healthcare.
By Shannon Muchmore • June 20, 2019 -
At AHIP19, a call to 'break glass' to survive fast-changing industry
Panelists at AHIP, including former CVS head Andy Slavitt, called for disruption across healthcare, including increasing partnerships among providers, payers and home health companies.
By Kim Dixon • June 20, 2019 -
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 -
Public option, increased premium credits could save $12B
Such changes would also provide coverage for an additional 1.2 million people, according to a report from the Urban Institute.
By Shannon Muchmore • June 19, 2019 -
Providers ready to take on more risk, survey shows
A Navigant survey of 170 hospital and healthcare system senior finance executives shows 72% plan to take on additional risk over the next one to three years.
By Dana Elfin • June 19, 2019 -
AHIP19: Cigna CEO says 'society demands more' from industry
David Cordani addressed consumer frustration and the industry's need to improve, especially when it comes to curbing costs, opening the payer group's annual conference.
By Samantha Liss • June 19, 2019 -
CMS proposes rule to set Part D electronic prior authorization standards
Under the standard, providers can use an electronic prescribing system or EHRs to determine whether a plan requires prior authorization for the medication being prescribed and submit the information in real time.
By Shannon Muchmore • June 18, 2019 -
Getty / Edited by BioPharma Dive
Gene therapy costs, manufacturing keeping FDA biotech head 'up at night'
"When the cost of goods are very high, they help justify when people charge astronomical prices," said FDA's Peter Marks. "If we can help see cost of goods and ability to manufacture reproducibly improve, I think that'll be a big thing."
By Andrew Dunn • June 18, 2019 -
Trump admin opens door to fundamental changes in healthcare benefits
Paul Fronstin of the Employee Benefit Research Institute said he doesn't expect a ton of uptick right away, but when the next recession hits, "the future of health benefits gets put to the test."
By Samantha Liss • June 17, 2019 -
MedPAC urges MA data, primary care reforms
Included in the recommendations to Congress are changes to slow the growth of ER spending in Medicare fee-for-service.
By Samantha Liss • June 14, 2019 -
Getty / Edited by BioPharma Dive
Bluebird sets $1.8M price tag for blood-disease gene therapy
Payers around the world are grappling with the launch of gene therapies, many of which promise one-time treatments that can avert long-term healthcare costs.
By Jonathan Gardner • June 14, 2019 -
CMS warned Trump policies would hike taxes, cause ACA disruption, internal memo says
Democratic leaders on the House Energy and Commerce Committee sent a letter Friday to HHS Secretary Alex Azar inquiring into the harmful effects of administration policies in light of what they called "damning" evidence.
By Rebecca Pifer • June 14, 2019 -
Florida health insurer sued over skimpy plans
The defendant, Health Insurance Innovations, is one of the 12 companies under investigation by the House Committee on Energy and Commerce for their work in pushing the plans to consumers.
By Rebecca Pifer • June 13, 2019 -
Payers, providers dig in on surprise billing proposals
Industry groups are testifying on the issue before Congress again Wednesday at the third hearing in as many months.
By Shannon Muchmore • June 12, 2019 -
Influential panel urges HIV prevention drug, forcing payer hands
The task force charged with making clinical recommendations is advising those at high risk of contracting HIV take a daily medication to prevent the disease, which will likely expand access to the treatment.
By Samantha Liss • June 12, 2019 -
AMA affirms opposition to single-payer in close vote
Other proposals the physician group adopted encourage a focus on vulnerable patients in alternative payment models, more scrutiny on pharmacy benefit managers' role in the drug supply chain and tweaks to the Affordable Care Act.
By Shannon Muchmore • June 12, 2019 -
Congress warns industry to hurry on surprise billing fix
"If you don't solve the problem, then we will solve the problem and none of you will like it," Rep. Michael Burgess, R-Texas, told payer and provider reps testifying Wednesday.
By Rebecca Pifer • June 12, 2019 -
Humana integrating real-time benefit check into Epic EHRs
"Not all EMR companies are created equal," Humana's president of retail told Healthcare Dive, but the insurer plans to collaborate with other health IT vendors on data sharing projects.
By Rebecca Pifer • Updated June 12, 2019 -
CVS Caremark service aims to help employers manage nontraditional benefit options
The move by the pharmacy benefits manager comes as employers and payers increasingly offer to cover digital health tools to track nutrition, exercise and sleep.
By Samantha Liss • June 11, 2019 -
Are teaching hospitals more expensive? A new JAMA study may surprise some
When comparing the total cost of care at 30 days for one episode, starting with hospitalization, researchers found major teaching hospitals were less expensive compared with nonteaching hospitals.
By Samantha Liss • June 10, 2019 -
Quest, LabCorp breach stirs questions of cybersecurity risk from outside vendors
The breach could result in new regulations and rules governing how U.S. companies select and assess their vendors, according to Moody's Investor Service.
By Rebecca Pifer • June 10, 2019 -
Getty / Edited by BioPharma Dive
Deep Dive
The gene therapy era has arrived. So have the challenges.
The chief medical officer for Harvard Pilgrim Health Care said Medicaid pricing law needs to change to enable flexibility for payers as they navigate a world with $2.1 million treatments.
By Andrew Dunn • June 10, 2019 -
Industry balks at Senate proposals to boost competition, price transparency
Employers and health policy experts argued banning certain contract clauses and making more information available to consumers would benefit patients in comments to the Senate HELP committee this week.
By Shannon Muchmore • June 7, 2019 -
Medicare beneficiaries prefer traditional over MA in 1st eligible year
A majority of new Medicare beneficiaries continue to opt into traditional plans over Medicare Advantage, suggesting the buzz around MA may be exaggerated, according to a Kaiser Family Foundation study.
By Rebecca Pifer • June 7, 2019 -
Price transparency proposals raise thorny questions
One hospital CEO is bucking the trend and embracing price disclosure, but the effectiveness of such requirements is unclear.
By Samantha Liss • June 7, 2019 -
CMS calls for ideas to cut red tape
Federal health regulators want to reduce the administrative burden and "needless paperwork" baked in the system and they're asking the public to submit ideas.
By Samantha Liss • June 7, 2019
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