Payer: Page 95
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Trump prods Congress on surprise billing ban
The president called unexpected high-cost medical bills "one of the biggest concerns Americans have about healthcare."
By Shannon Muchmore • May 9, 2019 -
Aetna launches app for Apple Watch
The app is designed to be a "check engine light" for a person's health, Aetna's head of consumer technology told Healthcare Dive.
By Rebecca Pifer Parduhn • May 8, 2019 -
ACOs less likely to leave Medicare program after 3rd year
Shared-savings bonus payments, higher financial performance benchmarks and lower-risk patients led to longer survival in MSSP, according to a Health Affairs study.
By Rebecca Pifer Parduhn • May 8, 2019 -
Elizabeth Regan/Healthcare Dive
Drugmakers will soon be required to disclose prices in TV ads
Forcing pharma's hand, the Trump administration finalized a proposal requiring list prices in direct-to-consumer advertising, a move that could result in a legal challenge from industry.
By Ned Pagliarulo • May 8, 2019 -
Payers had best individual market performance in 2018 since ACA began
A Kaiser Family Foundation analysis on the profitability of the ACA individual market also found insurers expect to pay a record amount of rebates to consumers for not meeting the medical loss ratio threshold in 2018.
By Rebecca Pifer Parduhn • May 8, 2019 -
Kaiser Permanente rolls out EHR-integrated program to tackle social determinants of health
The social health network, a partnership with Unite Us, will be available within three years to all 12.3 million Kaiser Permanente members and the communities it serves, the health system said.
By Meg Bryant • May 7, 2019 -
CMS interstate insurance idea rebuffed by payers, state regulators
Commenters advised the agency against further policymaking on the issue, arguing it could invite a "race to the bottom" that only stands to benefit insurers.
By Tony Abraham • May 7, 2019 -
Centene 'committed' to WellCare deal amid Humana takeover report
Analysts said they doubt such an acquisition would take place and suggested Humana may instead purchase Molina or a smaller Medicaid plan.
By Samantha Liss • May 7, 2019 -
Seniors switching to MA already have lower costs than traditional Medicare beneficiaries
A new Kaiser Family Foundation study raises questions about whether MA payment rates, which are based on spending for similar people in traditional Medicare, are too high.
By Rebecca Pifer Parduhn • May 7, 2019 -
CMS draft guidance clarifies hospital co-location policy
The American Hospital Association has repeatedly urged the agency to make its policy clear, noting some hospitals were dismantling co-location and shared service arrangements out of concern they would be found noncompliant.
By Meg Bryant • May 6, 2019 -
Insurers' message on 'Medicare for All': We're part of the answer
As CEOs addressed investors on first quarter conference calls, the tone varied, but one message emerged: The private sector has a role to play in healthcare reform.
By Samantha Liss • May 3, 2019 -
People spend less, use fewer services with consumer-directed health plans, study shows
A separate survey found that four in 10 people with employer-sponsored health coverage had trouble paying medical bills, premiums or out-of-pocket costs.
By Meg Bryant • May 3, 2019 -
Taylor McKnight/Healthcare Dive
CBO wades into 'Medicare for All' debate, sidesteps landmines for now
Providers and payers seized on the report to cement their opposition to single-payer policies, but the government agency avoided analysis of any specific plan.
By Tony Abraham • May 2, 2019 -
AHA asks for antitrust probe of Centene-WellCare deal
While Centene CEO Michael Neidorff has downplayed antitrust concerns over the deal, he acknowledged to investors last week that divestitures are likely, specifically in Nebraska and Missouri.
By Shannon Muchmore • May 2, 2019 -
Trump administration asks appeals court to toss entire ACA
DOJ urged the Fifth Circuit to uphold a trial court's ruling finding the law unconstitutional, marking a change for the government, which had previously said the remainder of the ACA was severable from its individual mandate.
By Dana Elfin • May 2, 2019 -
CMS seeks comments on state workarounds to ACA requirements
The agency has gradually pushed states to consider more so-called innovation waivers that can allow them to sidestep key tenets of the ACA in their health insurance markets.
By Rebecca Pifer Parduhn • May 2, 2019 -
Cigna beats in Q1, but analysts seek detail on Express Scripts
Company officials upped its annual guidance but sidestepped questions over comparing the PBM's business prior to the merger.
By Samantha Liss • May 2, 2019 -
Yujin Kim/Healthcare Dive
At gene therapy meeting, insurance execs grapple with expected cost
As more gene therapies move closer to market, questions around pricing and reimbursement have taken on greater urgency for regulators, payers and drugmakers.
By Ned Pagliarulo • May 1, 2019 -
Humana beats Q1 expectations as MA growth continues
CEO Bruce Broussard on Wednesday became the latest payer chief to speak out against "Medicare for All" type plans and highlighted the threat they pose to the Medicare Advantage market.
By Tony Abraham • May 1, 2019 -
Aetna boosts CVS Q1 beat
The first full quarter with Aetna under its umbrella, as well as increased prescription drug volume, helped fuel revenue growth for CVS.
By Samantha Liss • May 1, 2019 -
Civica Rx CEO predicts 'stampede' if Amazon's Haven succeeds
Others attending the World Healthcare Congress on Monday agreed, with Stanford Graduate School of Business professor Robert Pearl saying "disruption is inevitable."
By Rebecca Pifer Parduhn • April 30, 2019 -
More Medicaid insurers could be ticket to lowering premiums in ACA markets
An Urban Institute and Robert Wood Johnson Foundation report shows a correlation between states with lower premiums and broad Medicaid managed care coverage within the state.
By Meg Bryant • April 30, 2019 -
Once an albatross, Molina boasts 16% ACA margins
First-quarter earnings bested Wall Street's estimates, with net income soaring 85% to $198 million. The company reported a 9% dip in premium revenue, though executives said this was in line with their expectations.
By Samantha Liss • April 29, 2019 -
Prior authorization harms care, outcomes, radiation oncologists contend
Of the radiation oncologists polled by the American Society for Radiation Oncology, 93% said PA delays their patients from receiving life-saving treatment.
By Les Masterson • April 29, 2019 -
Deductibles soar in small business health insurance market
Small companies are turning to plans with restricted provider networks as a way to contain healthcare costs, insurance broker eHealth found.
By Les Masterson • April 29, 2019
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