Healthcare Payers

Cigna to Acquire Express Scripts for $67B to Expand Consumer Value

by Thomas Beaton

Update 8/24/2018: Cigna shareholders have overwhelmingly voted to approve the acquisition of Express Scripts.  Approximately 90 percent of shareholders voted in favor of the deal, which is...

CMS: Payers Must Make Claims Data Available to Beneficiaries

by Thomas Beaton

CMS Administrator Seema Verma recently called on healthcare payers to make claims data available to their beneficiaries. The agency also announced a new initiative called MyHealthEData to give patients...

UnitedHealthcare Integrates Apple Watch Into Wellness Incentives

by Thomas Beaton

UnitedHealthcare is integrating the Apple Watch into beneficiary wellness incentives, where members can earn the device and financial rewards by participating in a walking program aimed at improving...

BCBS Earned Positive ACA Health Plan Revenues in Uncertain Market

by Thomas Beaton

BlueCross BlueShield of North Carolina (BCBS of NC) earned positive ACA health plan revenues after years of financial losses, citing low medical claims and more available consumers after other payers...

Centene to Acquire Medicaid, Medicare Advantage Provider Group

by Thomas Beaton

Centene signed an agreement to acquire Florida-based Community Medical Holdings Corp (CMG), a community medical group, to expand Centene’s Medicaid, Medicare Advantage (MA), and marketplace...

Idaho’s Expansion of Association Health Plans Risks ACA Market

by Thomas Beaton

The Academy of Actuaries warned insurance officials and government leaders in Idaho that the decision to expand the sale of association health plans (AHP) will destabilize ACA individual health plan...

HCSC Invests $1.5B to Develop Insurance Affordability Solutions

by Thomas Beaton

HCSC is investing $1.5 billion to develop health insurance affordability solutions including employee wellness programs, ways to address social determinants of health, and collaborative care. Dubbed...

Uninsured Adults Apprehensive About Health Insurance Costs

by Thomas Beaton

About 71 percent of uninsured adults aware of open enrollment periods did not enroll in state or federally-based health plans because of apprehension to rising health insurance costs and waning...

Payer Meal Program Addresses Social Determinants of Health

by Thomas Beaton

Philadelphia-based Health Partners Plan (HPP) reduced blood glucose levels of diabetics and care utilization of other chronically ill members by implementing a healthy meal program to address...

Value-Based Care Key to Bipartisan Healthcare System Reform

by Thomas Beaton

A group of five governors developed a bipartisan plan to reform the US healthcare system by using value-based care strategies such as quality reporting, insurance stabilization policies, and...

Aetna Highlights Emerging Drivers of Value-Based Care

by Thomas Beaton

Payer-provider collaboration, holistic healthcare approaches that address the social determinants of health (SDOH), and the use of health IT tools will be among the most important drivers of...

Apple to Launch Healthcare, Wellness Clinics for Employees

by Thomas Beaton

Apple is launching a new healthcare venture, called AC Wellness, that will deliver healthcare and wellness services to the company’s employees, according to major news outlets. The health and...

Payers Address Opioid Safety Via Education, $0 Narcan Co-Pays

by Thomas Beaton

Commercial payers are addressing the nation’s opioid crisis and promoting opioid safety by funding patient education programs and waiving Narcan co-pays to reduce barriers to...

UnitedHealth Offers Data Analytics to CMS Bundled Payment Program

by Thomas Beaton

UnitedHealth Group will help support a new Medicare bundled payment program by offering data and analytics services to participating providers. The payer announced in a press release that it will...

Medicare Advantage Evaluation Requires Transparent Claims Data

by Thomas Beaton

The growth of the Medicare Advantage (MA)  market requires the release of more claims data to evaluate the commercial and government impact of the program, according to a recent JAMA commentary...

Employers, Employees Face Disconnect Over Wellness Programming

by Thomas Beaton

More than half of employers believe that their wellness programming is effective for improving health and reducing spending, but only a third of their employees think the same thing, according to a new...

96% of Payers Are Committed to Electronic Prior Authorization

by Thomas Beaton

The vast majority of payers are committed to implementing electronic prior authorization solutions as a way to address administrative problems with prior authorization procedures, according to research...

Idaho Prepares to Offer Association Health Plans to Consumers

by Thomas Beaton

Idaho will allow payers to offer association health plans (AHPs) that are not required to meet all of the consumer protections or benefits criteria included in the Affordable Care Act.   Governor...

Payer Housing Partnership Addresses Social Determinants of Health

by Thomas Beaton

Health Partners Plans (HPP) and two community programs in Philadelphia announced a partnership to address housing-related social determinants of health by connecting homeless individuals to healthcare...

Ongoing Payer Consolidation Leads to Consumer Premium Hikes

by Thomas Beaton

The four largest payers in the US have continued to get bigger over the past few years, said Leemore S. Dafny, a professor of the Bruce V. Rauner Professor of Business Administration at Harvard...