Tenet renews ties with Humana, Anthem

After years of a rocky relationship, Humana members will have in-network access to Tenet's hospitals, outpatient centers and physician groups. Anthem BC members will also have access to Tenet's providers in California. 

By Tony Abraham • Updated Jan. 16, 2019

Optum drives UnitedHealth Group's Q4, yearly earnings increases

The payer's health services arm, known for driving vertical integration at the nation's largest commercial insurer, surpassed $100 billion in revenue for the first time in 2018.

By Les Masterson • Jan. 15, 2019

Explore the Trendline➔

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

Payer, provider trends to watch in 2019

This year the industry will reckon with some massive changes set in motion in 2018, such as megamergers like CVS-Aetna and a judge's contentious declaration that the Affordable Care Act is no longer constitutional.

By Tony Abraham , Samantha Liss • Jan. 14, 2019

Judge orders DOJ to continue CVS-Aetna review despite government shutdown

Delaying the case indefinitely because of the ongoing shutdown could have "far-reaching consequences" on consumers, D.C. District Court Judge Richard Leon wrote in his order Friday.

By Samantha Liss • Jan. 14, 2019

Louisiana launching 'Netflix model' in Medicaid for hepatitis C drugs

The state is looking for a pharmaceutical partner on the project that will cap state spending on expensive treatments for the disease.

By Les Masterson • Jan. 14, 2019

About 1 in 5 healthcare payments is tied to value-based model

Participation in major clinical registries is growing on average 7% annually, according to the new paper on quality initiatives and resource needs. Tracking quality measures through registries is a critical step to value-based payments.

By Meg Bryant • Jan. 11, 2019

ONC to Congress: Room for improvement in data sharing

Ongoing barriers to seamless data sharing range from technical and financial to trust and business practices, according to the HHS IT department's latest progress report.

By Meg Bryant • Jan. 10, 2019

Few digital health companies studying impact in high-burden populations, study finds

Only 16 of the more than 100 studies the authors looked at assessed a digital health product's impact on outcomes, and none measured its effect on cost or access to care, according to the report in Health Affairs.

By Meg Bryant • Jan. 10, 2019

Government shutdown poses another hiccup for CVS-Aetna

CVS CEO Larry Merlo addressed the ongoing court review of the Aetna merger at J.P. Morgan's annual conference, saying it will not impede expected benefits from the marriage.

By Samantha Liss • Jan. 10, 2019

How AI could shape the health tech landscape in 2019

Highlights include technologies that seek to cut costs and promote patient health, especially in the areas of imaging, diagnostics, predictive analytics and administration.

By Rebecca Pifer • Jan. 10, 2019

Grassley to zoom in on drug pricing, insurance mergers as Senate panel chair

The new Republican chairman of the Senate Finance Committee pledged to scrutinize mergers such as the CVS-Aetna deal and work to allow cheaper drug imports from Canada.

By David Lim • Jan. 10, 2019

Even without the final stamp of approval, CVS/Aetna can start preparing for the work that lies ahead

3 ways the CVS/Aetna merger can make healthcare consumers happier.

By Peter Manoogian • Jan. 10, 2019

Medicare joint replacement program could succeed in more regions, Health Affairs study says

The mandatory bundled payment model first implemented in 2016 has shown some ability to cut spending without negatively affecting care quality.

By Les Masterson • Jan. 9, 2019

JPM19: Bluebird proposes installment plan for LentiGlobin gene therapy

The biotech company would receive further payments only if LentiGlobin keeps working, according to a theoretical payment scheme the company rolled out Tuesday.

By Kristin Jensen • Jan. 9, 2019

High-cost Medicare patients more likely to be younger, low-income

One of the greatest predictors of a high-cost patient was whether they are dually eligible due to chronic kidney disease.

By Samantha Liss • Jan. 9, 2019

Women make up only 13% of healthcare CEOs

On average, it takes women three to five years longer than men to reach the top executive position, according to a report from Oliver Wyman.

By Rebecca Pifer • Jan. 8, 2019

JPM19: Molina CEO confronts 'misperceptions'

At the annual conference Monday, CEO Joseph Zubretsky touted areas of growth, pointing to $1 billion in revenue opportunities this year in the payer's existing portfolio.

By Samantha Liss • Jan. 8, 2019

House Democrats hope to push all states to expand Medicaid

Meanwhile, some Republicans in D.C. support a partial Medicaid expansion for the 14 states that have not yet opened up their programs to include more residents.

By Les Masterson • Jan. 8, 2019

Centene inks deal to buy Arkansas health plan from CHI

The hospital chain has wanted to divest its insurance business for years, part of its ongoing plan to focus more on value-based payments and population health.

By Samantha Liss • Jan. 7, 2019

Cancer treatment choices may be skewed by financial incentives, study shows

Physicians in freestanding radiotherapy centers were more likely to self-refer radiation treatment for patients, according to the report in JAMA Oncology.

By Meg Bryant • Jan. 4, 2019

Hospitals see 'modest' 3% savings using Medicare joint replacement model, study finds

Those participating didn't see a significant difference in complications or percentage of procedures among high-risk patients, according to the report in the New England Journal of Medicine.

By Les Masterson • Jan. 4, 2019

Final ACA federal enrollment tally drops due to cancellations

The final numbers are roughly 43,000 lower than those CMS posted at the end of open enrollment last month and about 4% lower than figures a year ago.

By Rebecca Pifer • Jan. 4, 2019

Court rejects 340B payment cuts in big win for hospitals

The district court judge asked the federal government and hospitals to come to an "appropriate remedy."

By Les Masterson • Dec. 31, 2018

CMS unveils 'new direction' for MSSP that adds more risk on ACOs

The change also includes new beneficiary incentives, telehealth services and beneficiary assignment methodology choices.

By Les Masterson • Dec. 28, 2018

JAMA findings suggest 'unintended harm' from Hospital Readmissions Reduction Program

The study shows an association between the program and 30-day post-discharge mortality in heart failure patients.

By Meg Bryant • Dec. 21, 2018