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Private Payers News

Shareholder Class Action Lawsuit Filed Against Aetna

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A shareholder class action lawsuit has been filed against the national health insurance company Aetna Inc., according to a press release from the law firm of Kessler Topaz Meltzer & Check, LLP. The announcement came earlier this...

Top 4 Ways Payers Could Improve Patient Health Outcomes

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Health insurance companies have been putting more focus on preventive care, a reduction in unnecessary medical testing, and better patient health outcomes by transitioning to value-based care reimbursement. National payers have utilized a number...

Anthem Cut ER Costs by 3% with Value-Based Care Reimbursement

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  In recent years, the national health payer Anthem has been advancing value-based care reimbursement by collaborating with primary care providers and operating the Enhanced Personal Health Care program, according to a report released...

Vermont Blue Cross Plan Reaches Highest Member Satisfaction

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Blue Cross and Blue Shield of Vermont (BCBSVT) announced in a company press release this month that the payer has achieved the highest scores for member satisfaction and efficiency rankings for the fourth continuous year. This particular Blue...

Why a Court Stopped the Aetna-Humana Health Insurance Merger

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On January 23, Judge John D. Bates of the Federal District Court for the District of Columbia ruled that the Aetna-Humana health insurance merger would lead to antitrust problems and was not allowed to continue. The Coalition to Protect Patient...

Federal Court Blocks Aetna-Humana Health Insurance Merger

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Today, a federal judge ruled that the health insurance merger between the healthcare payers Aetna and Humana should be blocked on the grounds that it would create antitrust issues, according to The New York Times. The health insurance...

UnitedHealthcare Adopts Bundled Payment Model for Surgeries

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The national health insurance company UnitedHealthcare has followed the lead of the Centers for Medicare & Medicaid Services (CMS) and implemented a bundled payment model specifically for hip, spine and knee surgeries much like...

Aetna, Humana, Harvard Pilgrim Target Patient Health Outcomes

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Commercial health insurance companies have pursued a number of different approaches to improve patient health outcomes and reduce wasteful medical spending. The payers Aetna, Humana, and Harvard Pilgrim conducted some key collaborations to achieve...

Humana Advances Population Health Management, Value-Based Care

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The health insurer Humana has been progressing with population health management and value-based care by partnering with the population health company FullWell in December 2016, according to a company press release. The partnership creates a...

Cigna Partners with Scripps Health in Pay-for-Performance Model

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The national health insurer Cigna announced in a company press release yesterday that it will be partnering with the nonprofit healthcare delivery system Scripps Health through a pay-for-performance contract to provide employers in the San Diego...

Cigna’s Key Principles for Healthcare Quality Measures

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Cigna is one national health insurance company that has moved forward with creating successful healthcare quality measures for their provider networks. The company uses national standards along with physician feedback when creating its own healthcare...

Key Steps for Payers to Improve Population Health Management

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In recent years, population health management has become a larger factor in the success of a health insurance company. With more payers transitioning to value-based care reimbursement platforms, the quality of care and patient outcomes have grown...

Humana, Aetna, Cigna Invest in Value-Based Care Payment Models

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Value-based care payment models are continuing to make headlines among major health insurance companies around the nation. Last month, Humana entered into a value-based care arrangement with the population health management company Fullwell,...

Blue Cross Health Plans Expand Value-Based Care Reimbursement

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Along with other national payers, Blue Cross Blue Shield health plans have been investing in expanding value-based care reimbursement. For example, New York-based Excellus Blue Cross Blue Shield has partnered with vendors to use analytics and...

How Blue Cross Health Plans Affect Anthem-Cigna Merger Lawsuit

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The Anthem-Cigna merger lawsuit has brought significant evidence to light ever since the case began on November 21, 2016. The Department of Justice has been able to illuminate that the health insurance merger would create major market concentration...

Humana Standardizes Healthcare Quality Measures for Physicians

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Last week, Humana announced in a company press release the development of a Clinical Quality Metrics Alignment (CQMA) program meant to simplify and regulate healthcare quality measures. The new strategy will be used specifically among doctors...

UnitedHealthcare Cut Costs through Value-Based Care Programs

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Last month, UnitedHealthcare released a report outlining the benefits of value-based care programs. The report called Collaborative and Coordinated: How Value-Based Care Programs are Driving Improvements in Quality and People’s Health began...

How 4 Healthcare Payers Fare in 2016’s Health Insurance Market

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The health insurance market has gone through significant changes in 2016. A number of payers have pulled back from the health insurance exchanges such as UnitedHealth and Humana. The Department of Justice has also filed lawsuits against the mergers...

AMA: Health Insurance Merger Cuts Medicare Advantage Competition

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The American Medical Association (AMA) announced in a press release earlier this week their position against the health insurance merger between Aetna and Humana, particularly regarding its impact on the Medicare Advantage market. The AMA is...

Payers See High Financial Losses on Health Insurance Exchanges

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Healthcare payers have been facing significant financial losses on the health insurance exchanges in recent years. UnitedHealth Group lost $475 million in 2015 and was predicting a loss of $650 million in 2016, according to Kaiser Health News....

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