Payer: Page 97


  • Focus on usability, interoperability to help reduce health IT burden, groups tell ONC

    Stakeholders also urged ONC to consider artificial intelligence tools as a means of relieving hassles from EHR use.

    By Jan. 29, 2019
  • CVS-Aetna to offer Apple Watch app for members

    The Attain app will allow Aetna members to set personalized activity goals, participate in weekly challenges and earn rewards as they reach milestones.

    By Jan. 29, 2019
  • Explore the Trendline
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    Payer/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
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    Doctors less likely to accept Medicaid than other insurance

    MACPAC found no difference in Medicaid acceptance between doctors in states that expanded the program under the ACA and those that didn't — except with OB-GYNs.

    By Les Masterson • Jan. 28, 2019
  • JAMA study makes case for investing in primary care

    People with primary care receive more high-value care, slightly more low-value care and report better healthcare experiences than those without primary care, according to a new study in JAMA Internal Medicine.

    By Jan. 28, 2019
  • Aetna, Anthem pilot seeks blockchain potential in healthcare

    The initiative — which includes Health Care Service Corporation, IBM and PNC Bank — hopes to leverage blockchain for claims processing and health information exchange, among other potential uses.

    By Jan. 25, 2019
  • Fewer Americans see doctors in their office, CDC data show

    Chronic conditions were the leading reason for physician office visits in 2016, followed by "new problems" and preventive care.

    By Jan. 25, 2019
  • Medicaid advisory panel calls for phasing in DSH allotment reductions

    The suggestions also include changes in how disproportionate share hospital spending is allocated, and are projected to save the government anywhere from $1 billion to $5 billion over the next decade.

    By Jan. 25, 2019
  • ACA exchanges showing stability after rocky years

    More payers are offering Affordable Care Act plans and premium increases are relatively modest despite attempts from Washington to undermine the law, according to a report from the Urban Institute.

    By Les Masterson • Jan. 25, 2019
  • Fitbit targets newest activity trackers at health, wellness plans

    Fitbit Inspire and Inspire HR are available solely through the company's corporate partners and affiliates.

    By Jan. 24, 2019
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    Double-digit growth in hip, knee replacements driving healthcare spending

    A new analysis shows a growing proportion of Blue Cross Blue Shield members are electing to undergo the orthopaedic procedures.

    By Nick Paul Taylor • Jan. 24, 2019
  • Hospital groups push shared infrastructure, rules of road to boost interoperability

    Data sharing barriers include lack of standard vocabulary between health IT platforms and changing regulatory requirements and timelines, the American Hospital Association and six other groups said in a report.

    By Jan. 23, 2019
  • Walgreens pays $270M to settle Medicaid fraud allegations

    For years, the U.S. government alleges, the pharmacy giant routinely submitted false data to improperly secure federal reimbursement for insulin pens not needed by patients.

    By Suzanne Elvidge • Jan. 23, 2019
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    Number of uninsured adults reaches post-ACA high

    The uninsured rate reached a four-year high at nearly 14% in the fourth quarter of last year, according to a new Gallup poll.

    By Tony Abraham , Jan. 23, 2019
  • Downside risk spurs provider exodus in bundled payment models, GAO says

    The watchdog also found provider groups participating in any of the six bundled payment models from CMS had larger practices and higher care episode volume on average, and were more likely to be located in urban areas.

    By Jan. 23, 2019
  • CMS approves 8th state for Medicaid work requirement

    Arizona's policy is expected to begin in 2020 and affect about 120,000 residents.

    By Les Masterson • Jan. 22, 2019
  • Private equity boost, upskilling workers among 2019 sector trends, PwC reports

    With the average health insurance deductible triple what it was a decade ago, the consultancy believes 2019 could also be the year for value line products and services — similar to the Southwest Airlines approach.

    By Jan. 18, 2019
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    CMS pitches new MA and Part D voluntary payment models

    The MA model will test new service delivery approaches, including telehealth expansion, while the Part D model aims to control catastrophic drug spending by front-loading insurers with higher risk. 

    By Jan. 18, 2019
  • eTransactions saw usage upswing in 2018: report

    Findings from the Council for Affordable Quality Healthcare show real momentum for electronic administrative transactions, a crucial step toward reducing physician burnout and increasing workplace efficiency.

    By Jan. 18, 2019
  • CVS, Walmart resolve spat over pharmacy benefit pricing

    The pact comes days after the two heavyweights said they'd hit a stalemate in contract negotiations.

    By Kim Dixon • Jan. 18, 2019
  • CMS cuts ACA exchange fees, floats proposal to end silver-loading

    While no regulations limiting or banning auto-enrollment and silver-loading are contained in the rule, the agency has requested public comment on the two issues for consideration in future rules before 2021.

    By Tony Abraham • Jan. 18, 2019
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    More seniors may soon be sporting Apple Watches with MA partnerships

    Tapping into the Medicare market could be lucrative for Apple and a good business strategy for insurers, given the aging U.S. population and rising healthcare costs.

    By Jan. 17, 2019
  • Appeals court upholds ruling against UnitedHealth in out-of-network billing case

    The lawsuit involved the practice of cross-plan offsetting, wherein insurers recoup one plan's overpayment to out-of-network providers by reducing another plan's payment to the same provider.

    By Jan. 17, 2019
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    No single solution to patient matching challenge, GAO says

    Questions about the accuracy of digital matching tools force providers to recheck results manually, according to the government watchdog.

    By Jan. 16, 2019
  • Massachusetts will ask Medicaid patients to rate their doctors

    Nearly 250,000 beneficiaries will receive questions about primary care, mental health treatment and long-term care services in what the state says is a first-of-its-kind project.

    By Les Masterson • Jan. 16, 2019
  • Study shows impact of urgent care centers on nonemergent ED usage

    The effect was limited to areas with multiple urgent care centers and privately insured patients, according to the National Bureau of Economic Research.

    By Jan. 15, 2019