Payer: Page 93
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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 Parduhn • 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 Parduhn • 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 Parduhn • 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 Parduhn • May 22, 2019 -
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 Parduhn • May 22, 2019 -
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 Parduhn • 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
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