Payer: Page 88
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Industry groups square off on surprise billing
A Congressional hearing on the topic Tuesday came after President Donald Trump highlighted the issue earlier this month and called for a bipartisan solution that protects patients in all insurance markets.
By Shannon Muchmore • May 22, 2019 -
MA beneficiaries disproportionately affected by social determinants of health
A new report from Avalere reiterates the importance of insurance plans offering a comprehensive set of benefits to tackle social determinants of health.
By Rebecca Pifer • May 22, 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 -
Show me the evidence, judge tells short-term health plan rule challengers
The government and patient advocate groups faced off in court over a final rule expanding access to short-term health insurance plans. A ruling is not expected until later this summer.
By Dana Elfin • May 22, 2019 -
UnitedHealth named most valuable healthcare brand
Insurers dominated consulting firm Brand Finance's top 10 list of most valuable healthcare brands for 2019. Other companies recognized were Anthem, Aetna, Medtronic, Fresenius, HCA and Centene.
By Samantha Liss • May 22, 2019 -
More practices open to downside risk, AMGA finds
But practices listed a number of barriers to the ongoing transition to value-based payments, including lack of access to administrative claims data and physician compensation issues, according to the survey.
By Shannon Muchmore • May 22, 2019 -
Private payers cover more than 40% of drug costs
Patients pay 14% of overall retail drug spend in the U.S. in the form of out-of-pocket costs, according to a new analysis from the Kaiser Family Foundation.
By Rebecca Pifer • May 21, 2019 -
5 state AGs push judge to approve CVS-Aetna merger agreement
The states originally opposed the deal but said they are satisfied with the current merger agreement.
By Samantha Liss • May 20, 2019 -
Healthcare spending accelerated in Q1, Altarum finds
A new report shows healthcare prices are growing more slowly than the prices of all other goods, continuing a 20-month trend.
By Samantha Liss • May 20, 2019 -
Gilead CEO pressured on PrEP pricing at House hearing
Critics of Gilead contend it had little to do with the research behind Truvada's use as a preventive therapy — a charge CEO Daniel O'Day rebutted.
By Ned Pagliarulo • May 20, 2019 -
Wyden introduces price transparency bill targeting payers
The legislation stipulates that commercial insurers, as well as Medicare plans, provide an online tool and toll-free phone number for members to ask about cost of services and quality of providers.
By Shannon Muchmore • May 17, 2019 -
Express Scripts plans formulary for apps, medical devices
A list of digital health tools, including smartphone apps and software-enabled medical devices, is aimed at helping patients manage their health.
By Rebecca Pifer • May 17, 2019 -
JP Morgan expands footprint in healthcare payment game
Philadelphia-based InstaMed, the financial giant's new acquisition, is particularly focused on eliminating paper from the labyrinthine healthcare payments system.
By Dana Elfin • May 17, 2019 -
CMS pulls back on key Part D proposals
While the final rule is seen as a win for pharmas and insurers, pharmacists and drugstores were not pleased.
By Samantha Liss • Updated May 20, 2019 -
Small PBMs urge Congress: Don't kill rebates
An HHS rule that would eliminate Medicare and Medicaid drug rebates could have the unintended effect of raising patients' drug costs, one executive said.
By Samantha Liss • May 16, 2019 -
CMS targets PBM spread pricing
The agency is concerned the practice of charging pharmacists and health plans different prices for the same drugs is inflating costs and increasing the burden on taxpayers.
By Samantha Liss • May 16, 2019 -
Patients aren't sold on virtual health benefits, payers find
Health plans have been quick to embrace virtual care despite issues surrounding outcomes and access. A new survey from AHIP found most payers are facing unexpected challenges with patient adoption of virtual care.
By Tony Abraham • May 16, 2019 -
Federal lawmakers put forward competing proposals to ban surprise billing, with key difference
Both bills are bipartisan, but a draft bill in the House does not include arbitration, while the Senate plan does. The American Hospital Association supports such a provision, while the payer lobby group strictly opposes it.
By Shannon Muchmore • Updated May 16, 2019 -
FTC commissioner: M&A outpacing agency funding
The regulator and other enforcers face multiple challenges in bringing enforcement actions against hospitals, FTC Commissioner Rebecca Kelly Slaughter said.
By Dana Elfin • May 15, 2019 -
Danielle Ternes/Healthcare Dive
Deep DiveOn the path to patients, NASH drugs may hit a payer roadblock
Wall Street estimates and clinical data suggest the earliest NASH drugs could come with limited efficacy but high price tags. Healthcare providers fear that won't sit well with payers.
By Jacob Bell • May 15, 2019 -
DOJ loses fight to limit CVS-Aetna testimony
The judge said it is "essential" to understand how pharmacy benefit management services affect Medicare Part D drug plans, which make up the scope of the merger settlement agreement.
By Samantha Liss • May 14, 2019 -
Cancer patients face sticker shock under short-term plans, study finds
Short-term insurance plans are facing scrutiny from Congress and patient advocates, who argue consumers are often unaware the plans offer only bare-bones coverage.
By Dana Elfin • May 14, 2019 -
As Trump wades in, states move on surprise billing
The political climate in Washington, where even historically bipartisan efforts move slowly at best, has left states to step in and do what they can.
By Shannon Muchmore • May 14, 2019 -
Kaiser Permanente's net income soars to $3.2B in Q1
The California-based integrated health system's financials are in line with a trend for non-profits after several years of expenses outstripping revenues.
By Samantha Liss • May 14, 2019 -
Uninsurance of children, parents inched back up in 2017, report finds
Both children and parents were more likely to be uninsured in states without Medicaid expansion, according to new research from the Urban Institute.
By Meg Bryant • May 13, 2019 -
Health plans improve on coverage, benefits but lag on costs, member expectations
Overall satisfaction is 245 points higher when members view their health plan as actively trying to lower their out-of-pocket costs and coordinate care, according to a J.D. Power study.
By Meg Bryant • May 13, 2019
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