Payer: Page 87
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Judge, CVS witness clash on merger settlement, July hearing set
Federal Judge Richard Leon told lawyers they might want to cancel their summer vacation plans as he voiced concern about the leverage the merged health giant will wield in the marketplace.
By Dana Elfin • June 6, 2019 -
Americans want their doctors to ask about social needs
A national survey conducted by Kaiser Permanente revealed that 74% of Americans are frequently stressed over meeting the needs of their families when it comes food and housing.
By Samantha Liss • June 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 -
Enrollment in standalone Medicare Part D plans drops slightly
The decline marks the first dip since the program's inception in 2006, according to a new report from the Kaiser Family Foundation.
By Samantha Liss • June 5, 2019 -
AMA witness tells judge CVS-Aetna merger creates significant competitive concerns
The judge determining the adequacy of the CVS-Aetna merger settlement with the government asked the witness whether he should go beyond the union's effects in the Medicare Part D market.
By Dana Elfin • June 4, 2019 -
CVS to open 1.5K HealthHUB stores in next 2 years
The pharmacy chain's shares were up 3% premarket Tuesday following the news, which was released in tandem with the company's 2019 Investor Day.
By Rebecca Pifer • June 4, 2019 -
Utah wants capped Medicaid enrollment, spending
In a new demonstration waiver, the state proposes capping the growth rate of federal payments for its limited Medicaid expansion at the rate of medical inflation, rather than the usual, lower rate of consumer price inflation.
By Rebecca Pifer • June 3, 2019 -
ONC exploring ways to streamline electronic prior authorization
The HHS IT chief criticized the current state of electronic prior authorization at Academy Health's conference Monday, calling it a "non-computerized kabuki of payment" that "needs to get rethought."
By Rebecca Pifer • June 3, 2019 -
What's at stake in CVS-Aetna merger hearing: 4 questions
Judge Richard Leon will hear testimony from proponents and opponents of DOJ's settlement agreement with CVS and Aetna at what is shaping up to be a contentious hearing starting Tuesday in federal court.
By Dana Elfin • June 3, 2019 -
Humana says it won't bid on Centene
Amid significant investor chatter and speculation about Humana possibly making a play for Centene, the insurer bucked its no-comment policy to clear up those rumors and said it wouldn't attempt an acquisition.
By Samantha Liss • June 3, 2019 -
UHS partners with Vera on primary care
The hospital chain will receive a minority stake in Vera as part of the deal.
By Samantha Liss • May 31, 2019 -
Heightened drug price scrutiny not likely to hurt insurers much, Fitch says
"Until a clear consensus for legislative change emerges, there is limited potential for a major disruption to the status quo," analysts wrote.
By Rebecca Pifer • May 31, 2019 -
DOJ loses bid to change contours of CVS-Aetna settlement hearing
The government argued the procedures for the three-day hearing set to start next week needed to be modified but the judge rejected the bid late Thursday, calling it an "eleventh-hour request to reshape next week's hearing."
By Dana Elfin • Updated May 31, 2019 -
Provider groups slam rate setting in House surprise billing draft legislation
Health systems and other providers worry if rate setting is enacted it will become the default payment for healthcare services and hurt their bottom lines.
By Rebecca Pifer • May 30, 2019 -
Safety net hospitals fall behind in Medicare joint replacement model
The results could be because of inferior, higher-cost care from safety net hospitals or because the program "does not account for the increased social vulnerabilities of patients" in those facilities, the study authors wrote.
By Shannon Muchmore • May 29, 2019 -
Centene doubles down on commitment to WellCare deal
Reports suggest activist investors are not sold on the idea of the union and want Centene to sell itself.
By Samantha Liss • May 29, 2019 -
Seniors' out-of-pocket spending on cancer drugs continues to climb
Despite efforts to limit Medicare Part D beneficiaries' financial exposure to high-cost drugs, price increases have wiped out some of the expected savings.
By Samantha Liss • May 29, 2019 -
Upcoding may have led to higher MA payments
New research points to overstated risk differences between Medicare Advantage and traditional fee-for-service populations, which the authors say are the result of upcoding within the risk adjustment system.
By Tony Abraham • May 28, 2019 -
Senate health committee takes on surprise bills, price transparency in legislative package
The American Hospital Association said it was "concerned about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers."
By Shannon Muchmore • May 24, 2019 -
Does an echocardiogram cost $210 or $1,830? UnitedHealth calls out price variation.
The parent company of the nation's largest commercial insurer said the differences lead to more than $18 billion of overspending in healthcare.
By Samantha Liss • May 24, 2019 -
Novartis gene therapy approved, but will come at cost of more than $2M
Zolgensma is designed to be a cure for spinal muscular atrophy, but its steep price will pose difficulties for a system designed for chronic therapy rather than one-time treatments.
By Ned Pagliarulo • Updated May 24, 2019 -
Pay-for-delay deals disappearing, FTC says
The federal agency conceded branded and generic makers may be striking non-monetary deals that impede price competition on off-patent drugs.
By Jonathan Gardner • Updated May 24, 2019 -
Centene-WellCare shareholder votes set for next month
A new SEC filing outlines terms of the deal, including termination fees and board structure.
By Samantha Liss • May 24, 2019 -
Payer Q1 earnings boom as political risk looms, Moody's says
All publicly traded payer earnings in Q1 were either credit-neutral or positive, according to a new report from the investment firm. Major risks to upward-trending growth include merger integrations and single-payer reforms.
By Tony Abraham • May 24, 2019 -
CMS home-based primary care model yields mixed results
The model had some success in lowering Medicare expenditures over the four-year term but resulted in significantly higher spending, according to an outside analysis.
By Rebecca Pifer • May 24, 2019 -
Dual eligible MA beneficiaries receive better care at lower costs than FFS
Dual eligibles in MA plans also received more preventive care and had significantly lower rates of health complications than those in traditional Medicare, according to an analysis from consulting firm Avalere.
By Rebecca Pifer • May 22, 2019
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