Payer: Page 90
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Spending on primary care paltry, but some states ramping up
Increasing spending on primary care lowers emergency department visits and hospitalizations, according to the Patient Centered Primary Care Collaborative's 2019 Evidence Report, but America isn't funding it.
By Rebecca Pifer Parduhn • July 17, 2019 -
Surprise billing legislation saves $7.6B, trims premiums, budget watchdog says
The sweeping Senate bill, which also tackles drug costs and bars certain contracts between payers and providers, was passed out of committee with bipartisan support last week.
By Samantha Liss • July 17, 2019 -
CVS launches home hemodialysis device clinical trial
The drugstore giant, which now includes insurance heavyweight Aetna, said it can help reduce the $35 billion in Medicare costs associated with the treatment of end-stage renal disease.
By Shannon Muchmore • July 17, 2019 -
Surprise billing fight escalates as providers win arbitration add to House bill
Insurers and health policy experts are pushing back against the controversial change to the bill, which will let providers or payers appeal to an independent arbiter in cases where the median in-network rate tops $1,250.
By Rebecca Pifer Parduhn • Updated July 17, 2019 -
UnitedHealth to jumpstart Q2 results with eyes on volume, 'Medicare for All'
The healthcare giant will report its earnings Thursday, setting the stage for the rest of the season.
By Shannon Muchmore , Samantha Liss • July 16, 2019 -
CMS proposes Medicare cover acupuncture for patients in approved studies
Medicare doesn't usually cover alternative medical procedures, but the government is looking for ways to reduce the nation's dependence on highly addictive opioids for chronic pain.
By Rebecca Pifer Parduhn • July 16, 2019 -
Participation in APMs, MIPS climbed significantly in 2018
Many physicians have rejected the programs, saying they contain too many rules and rely too much on expensive investments in EHRs.
By Ron Shinkman • July 15, 2019 -
CMS proposes new home infusion therapy benefit
Home infusion therapy allows for the delivery of certain drugs, such as anti-infectives, chemotherapy or treatment for immune deficiencies, with the use of a durable medical equipment pump at a patient's home.
By David Lim • July 12, 2019 -
Deep Dive
ACA's legal jeopardy: 4 questions
The embattled landmark law is again before jurists, this time a panel of the Fifth Circuit Court of Appeals. Arguments this week offered more insight into what's at stake.
By Shannon Muchmore , Samantha Liss , Dana Elfin • July 11, 2019 -
White House pulls drug rebate rule to relief of payers
Withdrawal of the rule, which drugmakers supported, puts greater focus on the administration's plans for an international price index for certain doctor-administered drugs.
By Ned Pagliarulo • July 11, 2019 -
Appeals court judge on ACA: 'Congress can fix this'
Two Republican-appointed judges hammered Democrats on whether the ACA's individual mandate was severable from the rest of the law and asked why Congress expected them to find a solution.
By Samantha Liss , Dana Elfin • July 10, 2019 -
UK testing Netflix-style payments to boost antibiotics development
Officials hope the model will overcome some of the obstacles that have stifled the commercial prospects for new antibiotics.
By Jacob Bell • July 10, 2019 -
Air ambulance industry on defense as surprise billing debate heats up
Emergency air service providers are warning of base closures if surprise billing legislation working its way through Congress passes.
By Samantha Liss • July 10, 2019 -
UnitedHealth backs Inspire Medical's sleep apnea implant
The massive private payer deemed the Minnesota medtech's neurostimulation system medically necessary in patients with obstructive sleep apnea who have already tried CPAP therapy.
By Maria Rachal • July 10, 2019 -
Trump executive order seeks to overhaul US kidney care
The government push for home dialysis will help major payers like UnitedHealth Group, Cigna, Anthem and Humana and interested companies like CVS Health move into the space.
By Rebecca Pifer Parduhn • Updated July 10, 2019 -
In win for pharma, Trump TV drug price rule struck down
The federal district court sided with a drugmaker coalition that argued the government overstepped its authority in trying to force price transparency in advertisements.
By Jonathan Gardner • July 9, 2019 -
Pharma stocks slide as industry mulls Trump drug price action
Drug pricing is back in the spotlight as politicians grapple with ways to bring down healthcare costs. While the meaning of the president's comments wasn't clear, Monday's market reaction was unambiguous.
By Ned Pagliarulo • July 9, 2019 -
Republican bid to dismantle ACA takes center stage
A federal appeals court in New Orleans heard oral arguments Tuesday in a ruling that could send ripples across the industry.
By Dana Elfin • July 8, 2019 -
DOJ, House, states tell appeals court it has authority to hear ACA case
Ahead of Tuesday's oral argument, parties in the appeal over the constitutionality of the Affordable Care Act filed briefs telling the court it has jurisdiction because a live controversy exists.
By Dana Elfin • July 8, 2019 -
Healthcare Dive's 10 biggest stories of the spring
From Amazon pushing into the prescription delivery sector to CVS-Aetna struggling to finalize their merger settlement agreement, read the top stories from the first half of the year.
By Rebecca Pifer Parduhn • July 8, 2019 -
Doctors significantly over-allocated times to perform joint replacements, study shows
Time periods estimated to perform medical procedures, known as relative value units, are crucial for determining how much surgeons and other doctors are paid for their work under the Medicare Physician Fee Schedule.
By Ron Shinkman • July 3, 2019 -
Zolgensma set a new drug pricing bar. Insurers show some signs of pushback
One month after approval, a handful of payers — including Anthem — have adopted policies taking a more cautious stance than what the FDA set out in the gene therapy's label.
By Ned Pagliarulo • July 3, 2019 -
ACOs may need stronger financial incentives, like downside risk, to succeed
The proportion of ACOs taking downside risk has inched up in recent years but still represents a minority, a study published in Health Affairs found.
By Rebecca Pifer Parduhn • July 3, 2019 -
Brian Tucker/Healthcare Dive
Deep DiveCould NEMT's pivot to the commercial sector be a wrong turn?
Employers and commercial plans are increasingly looking to partner with players like Uber and Lyft for non-emergency medical transportation, raising thorny questions about the return on investment in a healthier population.
By Rebecca Pifer Parduhn • July 2, 2019 -
Air ambulance charges soar over most other providers
A new study in Health Affairs examines the price air ambulances charge Medicare, an important figure that reveals the potential financial exposure some patients may face if they receive a surprise, out-of-network bill.
By Samantha Liss • July 1, 2019
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