Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

Aetna Will Exit Iowa ACA Health Insurance Exchange in 2018

by

Aetna has announced that it will stop participating in the Iowa health insurance exchange in 2018, citing financial losses and market instability as primary reasons to exit.   "Earlier today we informed the appropriate federal and...

Wellmark BCBS Latest to Exit ACA Health Insurance Exchanges

by

Wellmark Blue Cross Blue Shield, which operates in Iowa and South Dakota, will not renew or sell individual plans on the Affordable Care Act health insurance exchanges effective Jan 1, 2018. The decision follows three-year losses of...

BCBS of Minn. Cites Risk Pools for $322.4M in 2016 Losses

by

Blue Cross Blue Shield (BCBS) of Minnesota reported a net operating loss of $322.4 million in their 2016 financial audit, citing unbalanced risk pools and rising premium pricing as a current and future detriment to profitability. At the...

Anthem Appeals Cigna Merger with Cost, Quality Arguments

by

Anthem has opened an appeal in the U.S District Court citing opportunities for increased consumer savings and quality of care weeks after the DOJ blocked its planned merger with Cigna. Anthem argued that the DoJ’s ruling neglected a...

Payers Face 9.6% Underwriting Loss on Health Insurance Exchange

by

Underwriting margins for payers selling individual plans on the health insurance exchange dropped from a 6 percent earned premium loss in 2014 to a 9.6 percent loss in 2015, Milliman recently reported. The financial losses stemmed from the...

AHA Urges D.C Appeals Court to “Uphold Cigna-Anthem Ruling”

by

The American Hospital Association (AHA) released a public document urging the U.S Court of Appeals in Washington D.C, to affirm the block on the Cigna-Anthem merger. In an amicus barae, the AHA outlined various antitrust violations and...

CBO Score Confirms Industry’s American Health Care Act Concerns

by

After the Congressional Budget Office released their cost estimate on the American Health Care Act (AHCA) several healthcare industry leadership groups reaffirmed their concerns about the bill, which may leave approximately  14...

Aetna, Cigna Join 300 Organizations in CAQH CORE Phase III

by

A new press release confirmed that Aetna and Cigna are now certified under CAQH CORE Phase III Operating Rules. Their certification will provide the entire CAQH CORE collaboration interoperable access to two of the largest payers in the...

Market Monopoly Cause of Court Blocking Cigna-Anthem Merger

by

The full opinion of United States District Court for the District of Columbia blocking Anthem’s acquisition of Cigna became publicly available earlier this week and provides details into the court’s decision. In the memorandum...

After Terminated Merger, Cigna Demands $13B from Anthem

by

UPDATE: Anthem has secured a restraining order against Cigna preventing the final dissolusion of the merger.  The temporary order will be reviewed during a Delaware Chancery Court hearing on April 10. After a court ruling ended...

Humana to Leave ACA Health Insurance Exchanges by 2018

by

Humana will halt sales of individual health insurance plans through the Affordable Care Act’s exchanges by 2018, which will leave more than 150,000 Humana customers without a carrier.   Amid ongoing political uncertainty,...

Aetna, Humana Terminate Merger Deal After Court Defeat

by

Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part of the original agreement. The DOJ...

Federal Judge Strikes Down Cigna-Anthem Health Insurance Merger

by

A federal judge in Washington DC recently blocked a potential $48 billion health insurance merger between Cigna and Anthem, according to a Department of Justice (DoJ) press release. The two payers started the merger process back in the...

Shareholder Class Action Lawsuit Filed Against Aetna

by

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...

Top 4 Ways Payers Could Improve Patient Health Outcomes

by

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...

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

by

  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...

Vermont Blue Cross Plan Reaches Highest Member Satisfaction

by

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...

Why a Court Stopped the Aetna-Humana Health Insurance Merger

by

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...

Federal Court Blocks Aetna-Humana Health Insurance Merger

by

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...

UnitedHealthcare Adopts Bundled Payment Model for Surgeries

by

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...

X

Sign up for our free newsletter:

Our privacy policy


no, thanks

Continue to site...