Payer: Page 88
-
UnitedHealth Group report targets rising hospital prices
The insurer said inpatient prices rose 4.5% annually from 2013 through 2017 — even though consumers' use of inpatient care dropped 5%.
By Linda Wilson • Aug. 14, 2019 -
Centene expands ACA offerings in 10 states
About 2 million people have health insurance coverage through the insurer's exchange products. The expansion in 10 markets will likely boost that figure.
By Samantha Liss • Aug. 14, 2019 -
Average marketplace premiums for 2020 show smallest increase ever
Rates are expected to rise very modestly for those shopping for individual coverage. Colorado will actually see a decrease in average premiums, according to a report from Charles Gaba of ACASignups.net.
By Samantha Liss • Aug. 13, 2019 -
ACA market continues to lose those who don't qualify for financial help
Six states lost 50% or more of their unsubsidized population, or people who don't qualify for financial help. Iowa lost 85% of such customers.
By Samantha Liss • Aug. 13, 2019 -
Large employers look to virtual care to tackle high-cost claims in 2020, survey finds
The total cost of health benefits is expected to increase by 5% in 2020, in line with 2019. Of the 147 companies polled, 85% said expensive drugs were a top pharmacy-related concern.
By Dana Elfin • Aug. 13, 2019 -
Rite Aid names new CEO
Heyward Donigan is a seasoned healthcare executive, suggesting that the drugstore will join rivals in emphasizing medical services over retail.
By Daphne Howland • Aug. 13, 2019 -
Surprise bills surge in ER, inpatient settings, JAMA finds
The study comes as lawmakers prepare to debate legislation tackling the problem, including a Senate bill that sets a payment standard for out-of-network services. Providers are pushing back.
By Shannon Muchmore • Aug. 12, 2019 -
Kaiser Permanente net income soars to $2B
The integrated health system said the first half of the year typically delivers stronger results due to open enrollment.
By Samantha Liss • Aug. 12, 2019 -
Lack of tech, not jobs, could ding Medicaid enrollees facing work requirements
A large proportion of enrollees in the 16 states attempting to impose work requirements on Medicaid beneficiaries already have jobs or are providing care for someone in their household, according to the Kaiser Family Foundation.
By Ron Shinkman • Aug. 12, 2019 -
North Carolina folds to provider pressure with insurance plan shifting away from set rates
The new hybrid network will consist of more than 68,000 providers. The initial proposed State Health Plan network included only 28,000.
By Rebecca Pifer Parduhn • Aug. 9, 2019 -
Louisiana drops Aetna, Centene plans from 2020 Medicaid managed care contracts
The state public health department dropped the two vendors, which manage benefits for roughly a third of the state’s 1.7 million Medicaid enrollees.
By Ron Shinkman • Aug. 9, 2019 -
Courtesy of Gilead Sciences
Medicare boosts CAR-T cancer therapies with expanded coverage
CMS also broadened the settings in which the pricey therapies would be covered, applying its final rule to use in "healthcare facilities" rather than explicitly in hospitals.
By Ned Pagliarulo • Aug. 8, 2019 -
California surprise billing law disrupted contract negotiations, stakeholders say
The 2017 law was also perceived to have driven further provider consolidation in response to the leverage shift, according to research published in The American Journal of Managed Care.
By Shannon Muchmore • Aug. 7, 2019 -
Few patients price shop before planned hospital visit, survey finds
As CMS and lawmakers push for price transparency, the survey from a revenue cycle management software vendor suggests consumers may not know how to evaluate different options based on price, or even be aware that prices vary.
By Linda Wilson • Aug. 7, 2019 -
CVS handily beats estimates, hikes 2019 forecast
The tailwinds helping the chain in the first quarter kept blowing in the second, generating revenue of $63.4 billion largely due to the Aetna acquisition.
By Rebecca Pifer Parduhn • Aug. 7, 2019 -
Adeline Kon/Healthcare Dive
ColumnMyth Diagnosis: Do hospitals charge more to make up for low government pay?
"What is crystal clear is that there's a huge unit cost payment differential between government and commercial payers," John Pickering of Milliman said. "What isn't clear is whether there's a causal effect between those two."
By Shannon Muchmore • Aug. 7, 2019 -
Medicare Advantage market financially robust, attractive to insurers, report finds
Premium hikes coupled with slow claims growth made 2018 the most profitable year for individual market payers since the Affordable Care Act became effective, according to the Kaiser Family Foundation.
By Dana Elfin • Aug. 7, 2019 -
CVS expands at-home drug delivery program nationwide
The paid membership program is notably similar to Amazon's Prime membership as the two retail giants compete in emerging healthcare markets.
By Daphne Howland • Aug. 5, 2019 -
CMS tweaks hospital wage index change in final rule
The agency is heeding some concerns from hospital groups that facilities in urban areas would be unfairly dinged in the original plan, but the American Hospital Association isn't entirely on board with the new method either.
By Shannon Muchmore • Aug. 2, 2019 -
Anthem again irks docs with latest changes to reimbursement
"It is a nuisance. It makes absolutely no sense," dermatologist George Hruza said of the policy denying payment for certain follow-up office visits the same day a procedure is performed.
By Samantha Liss • Aug. 2, 2019 -
Cigna Q2 boosted by Express Scripts rebound
The payer nearly tripled its revenue in the second quarter and upped its guidance for the full year thanks to its pharmacy business.
By Samantha Liss • Aug. 1, 2019 -
Molina beats Q2 expectations despite drops in income, revenue
The insurer raised its guidance for the full year, suggesting it "isn't experiencing the challenges some MCOs have mentioned" in earlier reports for the second quarter, analysts at Jefferies said.
By Shannon Muchmore • July 31, 2019 -
White House backs importing drugs from abroad
The Trump administration's latest drug price plan features ideas Republicans traditionally oppose, and breaks with past claims about the FDA's ability to safely oversee importation.
By Jonathan Gardner • July 31, 2019 -
Humana sees biggest MA growth in a decade, steels for 2020 tax impact
Second quarter results beat analyst earnings and revenue estimates. The payer said it will invest some gains to offset pressure coming next year.
By Samantha Liss • July 31, 2019 -
Problems with Medicare Plan Finder to spur CMS revamp
The tool contains complex terminology the average layperson is unlikely to understand and makes consumers navigate through multiple pages before accessing plan details, according to a new government watchdog report.
By Rebecca Pifer Parduhn • July 31, 2019
Previous
