CMS has issued its proposed Payment Notice for the 2020 plan year, which contains provisions that would significantly alter the operations and structure of the ACA individual marketplace.
Continuing a...
Payers can expand primary care access in Delaware by progressively increasing primary care spending until it accounts for 12 percent of all healthcare investment, according to a report from...
Blue Cross and Blue Shield of North Carolina has launched Blue Premier, a new value-based care model that increases accountability for participating providers and their accountable care organizations...
Apple has approached several Medicare Advantage plan providers to discuss the idea of subsidizing its Apple Watch for at-risk seniors, according to industry reports.
CNBC reporter Christina Farr...
The Health Care Transformation Task Force (HCTTF) has released a new set of resources to support payers as they develop innovative bundled payment programs.
In a white paper titled Episode Groupers:...
With its $69 billion acquisition of Aetna in the books, the newly expanded CVS Health is now investing heavily in developing and deploying new models to address community wellness and the social...
Anthem Blue Cross (Anthem) Medicare Advantage members in California will now be allowed to purchase over-the-counter products at CVS Pharmacy stores using their health plan allowance.
The partnership,...
Mayor Bill de Blasio has announced the launch of a comprehensive, universal healthcare coverage plan that will guarantee benefits for every New Yorker.
“Healthcare is a right, not a privilege...
Change Healthcare and Health Fidelity have announced a collaboration to offer AI-driven risk adjustment coding solutions for Medicare Advantage, ACA commercial, and Medicaid payers.
The tool leverages...
The partial government shutdown will have no impact on Medicare and Medicaid at the federal level, CMS has stressed to industry observers.
The nation’s public payers will continue to operate as...
Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National...
Medicare Advantage (MA) plans are not doing enough to motivate their members to improve their personal health, according to a new survey from HealthMine.
Sixty percent of members participating in the...
Forty-five percent of adults aged 50 to 64 are not confident that they will be able to afford healthcare coverage in retirement, according to a poll conducted by the University of Michigan Institute...
AHIP is cautioning federal regulators to move slowly and carefully when expanding the availability of health reimbursement arrangements (HRAs) as a more prominent means of paying for healthcare...
2018 was a bad year to be a healthcare fraudster. The Department of Justice (DOJ) has announced that $2.5 billion of the total $2.8 billion recovered under the False Claims Act can be attributed...
Starting January 1, 2019, hospitals will be required to post their price lists online in an effort to increase price transparency and empower consumers to make informed choices about their care.
The...
Value-based care is nudging the half-way mark as more and more payers and providers shift their contracts away from fee-for-service arrangements, according to the Health Care Transformation Task Force...
Cigna is officially the new owner of Express Scripts after announcing on December 20 that the $67 billion acquisition has closed.
Cigna calls the acquisition a “blueprint to transform the...
It’s fair to say that the health payer community had a lot to process in 2018.
Mergers, partnerships, and new entries into the field rocked the traditional industry setup, while federal...
Several dozen pharmaceutical companies are planning to raise their prices again in 2019 after temporarily holding off on increases as a result of federal pressure.
Reuters reports that nearly thirty...
