Walgreens teams up with Alphabet's Verily on medication adherence pilot

The two companies said they are seeking to improve care for those with chronic conditions such as Type 2 diabetes.

By Samantha Liss • Dec. 20, 2018

ACA federal exchange enrollment drops about 4%

The slump is not as significant as many had feared, and shows the law is "far from dead," said Kaiser Family Foundation's Larry Levitt.

By Les Masterson • Dec. 20, 2018

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

Study finds 'mixed messages' in Medicare hospital ratings, penalty programs

The report echoes other findings that question the usefulness of hospital rankings.

By Meg Bryant • Dec. 19, 2018

ACA ruling could upend Medicaid expansion

Policy experts say it's hard to overstate the chaos the ruling would create if it stands, although many legal scholars doubt it will be upheld. Still, some managed care companies have contingency plans.

By Samantha Liss • Dec. 19, 2018

Reinsurance program, higher subsidies would further ACA coverage gains

In a new report, the Urban Institute suggested a variety of policy changes that it said would insure more than 12 million additional people.

By Les Masterson • Dec. 19, 2018

Cigna-Express Scripts deal complete

The $67 billion acquisition passed its final regulatory hurdle Tuesday with approval from New Jersey.

By Samantha Liss • Updated Dec. 20, 2018

Judge calls for expedited briefings in ACA case

The parties have until Friday to file their responses on whether a stay is warranted, whether the court should enter partial final judgment on the order and whether the court should certify the order for immediate repeal.

By Shannon Muchmore , Tony Abraham • Dec. 19, 2018

Mitigating waste in healthcare with analytics and interventions

Use targeted interventions to focus resources where they have the highest potential to yield results.

Dec. 19, 2018

Federal judge suggests CVS-Aetna be monitored by outside appointee

Judge Richard Leon of the D.C. District Court also rebuked the DOJ for its "tone deaf" brief questioning Leon's right to review the merger under 2004's Tunney Act.

By Rebecca Pifer • Dec. 18, 2018

One-third of healthcare employees say their company targeted by cybercriminals more than once

More than a quarter of those surveyed said their organization experienced a ransomware attack in the past year, according to a Kaspersky Lab report.

By Meg Bryant • Dec. 18, 2018

As providers merge, states look to supersede FTC

Tennessee, Virginia and West Virginia all recently passed laws to protect mergers from being blocked by federal antitrust regulators — in exchange for state regulation and prolonged oversight. 

By Samantha Liss • Dec. 18, 2018

HHS appeals risk adjustment court decision

CMS just released a new risk adjustment payment rule for benefit year 2018.

By Les Masterson • Dec. 18, 2018

Most Medicaid managed care programs consider social determinants of health

Still, few payment incentives involve those factors, according to a new report by the Association for Community Affiliated Plans and the Center for Health Care Strategies.

By Les Masterson • Dec. 17, 2018

Centene predicts 17% revenue growth for 2019

The payer, which specializes in Medicaid managed care, has grown membership by 17% this year and plans to continue expansion.

By Les Masterson • Dec. 17, 2018

CVS, DOJ defend marriage as judge remains skeptical

The responses come after a federal judge questioned whether the CVS-Aetna union is in the public's best interest.

By Samantha Liss • Dec. 17, 2018

California, New York OK Cigna-Express Scripts deal with conditions

The megamerger now waits on one more state — New Jersey — for final approval.

By Samantha Liss • Dec. 14, 2018

Fitch says payer sector stable, buoyed by MA rate increase, robust economy

There are debt issues related to M&A and concerns about the ACA exchanges over the next year, according to the ratings agency.

By Les Masterson • Dec. 14, 2018

DOJ takes up lawsuit accusing Sutter Health of cheating Medicare

The whistleblower lawsuit alleges the California health system and an affiliate manipulated diagnosis codes to inflate payments.

By Meg Bryant • Dec. 13, 2018

ACO trade group says Medicare program saved $859M in 2016

The program, which includes 561 accountable care organizations and 10.5 million patients, saved more than $660 million between 2013 and 2016 after bonuses paid to providers for meeting spending and quality targets.

By Les Masterson • Dec. 13, 2018

PwC: 'New Health Economy' finding its feet, but challenges remain

Providers are embracing digital treatments, with 77% saying they have suggested an app or digital program to a patient, according to the industry trends report.

By Meg Bryant • Dec. 12, 2018

1 in 5 patients at high risk of socioeconomic health problem, survey finds

Patients who discuss their social determinant of health challenges with a clinician are more likely to accept help, according to the study. Younger patients, while twice as likely to discuss, are less receptive to assistance.

By Tony Abraham • Dec. 12, 2018

4.2M Americans eligible for free ACA coverage, KFF says

In Iowa, Nebraska, Delaware and Utah alone, roughly half of potential marketplace shoppers could get a 2019 bronze plan with a $0 premium, according to the analysis.

By Rebecca Pifer • Dec. 12, 2018

Envision, UnitedHealthcare settle fierce nationwide contract squabble

If the two giant for-profit companies hadn't reached a deal, 27 million privately insured Americans could have been slammed with surprise emergency room bills as early as January.

By Rebecca Pifer • Dec. 11, 2018

What payers and providers need to know about reverification season

As plans renew and sponsors move into more restricted networks, the likelihood that several patients will have to switch to a different pharmacy is very real. 

Dec. 11, 2018

Payer, hospital groups trade blame on surprise billing

The problem of patients unexpectedly getting a bill for out-of-network services is common and growing, especially for people getting emergency room care.

By Les Masterson • Dec. 11, 2018