Payer: Page 86
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Consumers more likely to leave ACA after their insurer exits
A Health Affairs study also found that shoppers not qualifying for federal premium subsidies were twice as likely to leave when their payer did.
By Linda Wilson • Nov. 6, 2019 -
Centene, UnitedHealth big winners in $10B Texas Medicaid contracts
Meanwhile, medical cost ratios continued to pose challenges for many payers during the third quarter, according to recent earnings reports.
By Samantha Liss • Nov. 5, 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 -
Haven partners with traditional payers in plans offered to Amazon, JPM workers
The nonprofit formed early last year to tackle rising employee healthcare costs spooked established players but has since given few details about how it might accomplish its goals.
By Rebecca Pifer Parduhn • Nov. 5, 2019 -
Execs flirt with 'Medicare for All' at HLTH19, despite Trump admin warnings
"Until we see a better idea, it's actually not a bad framework to have a debate around," said the CEO of Medicare Advantage startup Clover Health.
By Rebecca Pifer Parduhn • Nov. 4, 2019 -
Litigation prompts Indiana to drop Medicaid work requirement for now
State officials had said the regulation might reduce its Medicaid rolls by about 5%, or 70,000 out of a total enrollment of 1.4 million.
By Ron Shinkman • Nov. 1, 2019 -
Georgia governor seeks to overhaul ACA market
Gov. Brian Kemp's proposal would push customers away from Healthcare.gov and steer them to sign up for coverage using online portals run by brokers.
By Ron Shinkman • Nov. 1, 2019 -
Cigna ups guidance after Q3 beat, boosted by Express Scripts
The payer generated adjusted revenue of $35.8 billion for the quarter, more than three times from a year earlier, thanks to the $67 billion acquisition of the pharmacy benefit manager completed in December.
By Samantha Liss • Oct. 31, 2019 -
CMMI head predicts industry will be 'very happy' with his replacement
"I worked very closely with the administration to identify somebody that has extremely similar values, that's concentrated on doing the right thing," Adam Boehler said Tuesday at the HLTH conference in Las Vegas.
By Rebecca Pifer Parduhn • Oct. 30, 2019 -
Molina 'disappointed' by $1B Texas contract loss, weighs protest
Total revenue and net income slipped during the third quarter compared with the prior year, but was in line with the insurer's expectations.
By Samantha Liss • Oct. 30, 2019 -
Kaiser Permanente rolls out food insecurity initiative in California
"Healthcare across the ecosystem of health plays a very small but important part" in outcomes, Kaiser CEO Bernard Tyson said Monday at HLTH. "Things like behavior, genetics and where you live has a bigger impact."
By Rebecca Pifer Parduhn • Oct. 29, 2019 -
HHS chief keeps focus on alternative payment models
Alex Azar on Tuesday hinted at further pushes from CMS on value-based care, including population health benefits like those newly allowed in Medicare Advantage and flat monthly payments for a patient's total cost of care.
By Shannon Muchmore • Oct. 29, 2019 -
CMS chief Verma teases more Medicaid deregulation
Speaking at the HLTH conference Sunday, Verma also said that as long as states continue to approach CMS with requests for Medicaid work requirements, the agency would approve them.
By Rebecca Pifer Parduhn • Oct. 28, 2019 -
US ordered to cough up $1.59B in subsidies to Kaiser, Oscar, other payers
Among the largest creditors in the case are Kaiser Foundation Health Plan, which is owed more than $220 million in cost-sharing reduction subsidies, and Blue Shield of California, with more than $132 million outstanding.
By Dana Elfin • Oct. 25, 2019 -
7 can't-miss panels at HLTH19
Some of healthcare's biggest names are converging in Las Vegas in just a few days for the second annual HLTH conference. We've combed through the dozens of panels so you don't have to.
By Rebecca Pifer Parduhn • Oct. 24, 2019 -
1/3 of US payments used alternative models last year, but progress stagnant
Medicare Advantage plans had the highest percentage of total payments tied to APMs, followed by traditional Medicare, commercial payers and Medicaid, a study from a private-public partnership found.
By Linda Wilson • Oct. 24, 2019 -
Anthem's Q3 revenue, income up as PBM launch moves forward
The payer's medical loss ratio, however, was up — hitting 87.2% for the third quarter this year from 84.8% last year and slightly above analyst predictions.
By Shannon Muchmore • Oct. 23, 2019 -
Deep Dive
5 insights from a chat with Larry Merlo, CEO of CVS Health
Healthcare Dive talked to Merlo, who rose up the ranks to lead the giant chain over three decades, about CVS' rivals, the path to the Aetna acquisition and potential arenas for disruption.
By Rebecca Pifer Parduhn • Oct. 23, 2019 -
Verma dodges on backup plan if ACA is struck down
Democrats accused the CMS administrator of stonewalling in her testimony in front of a House committee Wednesday, with a federal appeals court ruling on the fate of the landmark law expected any day.
By Rebecca Pifer Parduhn • Oct. 23, 2019 -
Trump admin touts dip in ACA exchange plan premiums
On average, those shopping for plans on the exchange will have more options at a lower price, CMS Administrator Seema Verma said Monday on a call with reporters.
By Samantha Liss • Oct. 22, 2019 -
Medicaid boosts Centene Q3, but medical loss ratio up
The payer also said its $17 billion acquisition of WellCare may close sooner than expected.
By Samantha Liss • Oct. 22, 2019 -
Humana, Microsoft ink 7-year deal for cloud services
The payer, which already partners with telehealth vendor Doctor on Demand for virtual primary care visits, will also develop similar tools with Microsoft.
By Rebecca Pifer Parduhn • Oct. 21, 2019 -
'Medicare for All' likely to keep private payers, but erode margins: Moody's
Several recent reports game out the costs and benefits of Democratic 2020 presidential hopefuls' healthcare proposals.
By Ron Shinkman • Oct. 18, 2019 -
Key committee pitches adding UDIs to insurance claim forms, called 'huge step'
If a unique device identifier is captured when a high-risk product is implanted, providers will be able to detect complications more quickly, said Joe Drozda, the director of outcomes research at Mercy Health.
By David Lim • Oct. 16, 2019 -
Overwhelming majority of providers loathe prior authorization requirements, survey shows
HHS is attempting to address the issue, proposing a rule in June to update electronic prior authorization requirements in Medicare Part D plans. The head of ONC has also called for an overhaul of the process.
By Shannon Muchmore • Oct. 16, 2019 -
UnitedHealth boasts $60B revenue in Q3, buoyed by Optum
The massive healthcare company kicked off managed care organizations' earnings season Tuesday by handily beating Wall Street expectations.
By Rebecca Pifer Parduhn • Oct. 15, 2019
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