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Private Payers News

Healthcare Payers Struggle with Price Transparency, Technology

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Health insurance companies are still struggling with improving price transparency in order to gain greater trust from their consumer base. One survey has shown low customer service satisfaction and a need for payers to inform consumers on their...

Private Payers Face Challenges on Health Insurance Exchanges

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The health insurance exchanges created after passage of the Affordable Care Act may not serve as a truly effective marketplace for commercial payers since some national insurers like Aetna and UnitedHealthcare have been dropping out of operating...

How Investing in Social Services Could Cut Healthcare Spending

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While healthcare spending is continually increasing, patient outcomes and overall health has not necessarily improved greatly, according to a report from Leavitt Partners and the Robert Wood Johnson Foundation. However, the study also...

How Provider-Sponsored Health Plans Can Compete for Consumers

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Provider organizations that take the leap to develop their own health plans compete in a highly competitive healthcare environment with established national, regional and local plans, and in some markets, new non-traditional entrants in the health...

Two Legal Arguments For and Against Health Insurance Mergers

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In 2015, the national insurer Anthem began proceedings to acquire Cigna while Aetna planned to merge with Humana. Very quickly, opposition lined up against the two planned health insurance mergers, with some arguing that bringing the top five...

How Healthcare Price Transparency Could Gain Consumer Loyalty

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The lack of price transparency remains a major concern of consumers that healthcare payers will need to address in the coming years. A HealthEdge survey shows that 88 percent of polled consumers are looking for better price transparency from...

Consumer Satisfaction Dips When Payers Lack Price Transparency

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Eighty-eight percent of consumers are looking for their health payer to relay complete information about their overall financial responsibility, according to a new survey by HealthEdge, indicating a strong desire for price transparency and openness....

Why Payers Should Consider Consumer Needs in Value-Based Care

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The Healthcare Financial Management Association (HFMA) released a new report called Health Care 2020: Consumerism showing that the health insurance industry has two new trends affecting it: a greater push toward patient cost sharing and outcomes-based...

Merger Suit Led Aetna to Drop out of Health Insurance Exchanges

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The national health payer Aetna may have chosen to reduce its participation in the Affordable Care Act’s health insurance exchanges due to the Department of Justice’s decision to pursue a lawsuit against the merger between Aetna and...

Comprehensive Primary Care Plus Program Selects Anthem BCBS

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The Centers for Medicare & Medicaid Services (CMS) has selected Anthem Blue Cross and Blue Shield in Colorado as a participant for their Comprehensive Primary Care Plus (CPC+) initiative, according to a company press release. The Comprehensive...

Health Insurance Acquisitions Impede Competition in 24 States

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The American Medical Association (AMA) announced today in a press release the results of a new study show that the health insurance acquisitions between Anthem-Cigna and Aetna-Humana would obstruct competition in the health insurance market throughout...

Why Aetna, Humana Argue in Favor of Health Insurance Merger

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On July 21, the Department of Justice (DOJ) announced during a press conference that they would be filing a lawsuit against two health insurance mergers between Aetna-Humana and Cigna-Anthem. The DOJ claimed that these health insurance mergers...

AMA Urges NY Regulators to Reject Health Insurance Mergers

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The Anthem-Cigna and Aetna-Humana health insurance mergers are facing more and more scrutiny throughout the medical industry and among federal officials. While the US Department of Justice filed a lawsuit against these health insurance mergers,...

How Healthcare Information Technology Boosts Member Engagement

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Healthcare information technology and communication channels remain an imperative aspect of the relationship between health payers and their consumers. As the healthcare industry continues to reform toward a value-based care platform, new legislation...

Payer Concentration Challenges Health Insurance Exchanges

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More and more research is pointing at the fact that consumers on the health insurance exchanges are being left with fewer health plan issuers. Part of this may be due to health payers such as UnitedHealthcare or Aetna leaving a large percentage...

Could Public Option Strengthen ACA Health Insurance Exchanges?

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The ACA health insurance exchanges are facing greater risk now that a number of healthcare payers have decided to drop out of the marketplace. UnitedHealthcare was the first to announce its departure from the ACA health insurance exchanges. More...

Did Aetna Need Merger to Stay in Health Insurance Exchanges?

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More and more payers are slowly dropping out of the Affordable Care Act’s health insurance exchanges. Earlier this year, UnitedHealth formally announced the decision to discontinue selling plans on the health insurance exchanges. More recently,...

Drop Outs in Exchanges, Health Insurance Merger Block Hit Market

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The health insurance market seems to be heading toward more and more consolidation as the major payers Humana and Aetna along with Cigna and Anthem seem to be bent on merging, which would essentially reduce competition and create consolidation...

Aetna Leaving Health Insurance Exchanges Due to DOJ Lawsuit

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The latest news coming from the major health payer Aetna is its move to drop out of the majority of the health insurance exchanges it had been participating in this year. According to a press release from Aetna, it will leave most of the public...

Affordable Care Act’s Reinsurance Programs Keep Market Stable

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One way that health payers can compete more effectively in the current destabilized environment is by investing resources in reinsurance programs. Reinsurance is a method in which a payer can buy a policy from other insurers in order to manage...

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