Author's posts
Verma calls on insurers to use APIs. Some answer more enthusiastically than others
For the second time this year, CMS Administrator Seema Verma called on insurers to follow the agency’s lead and release claims data in API format. Some insurers are more enthusiastic than others.
Oscar, Centene plan to stock up on IT talent
Oscar’s CTO said the company will double its engineering and product development workforce after a funding round from Alphabet, and Centene plans to fill 300 highly skilled IT positions.
CMS pushes ACOs to take on more risk with Medicare Shared Savings Program overhaul
A long-awaited rule from CMS would shorten the time frame that ACOs are allowed to be in an upside-only risk model to two years, a move that is likely to drive providers out of the program.
In Medicare Advantage market, Cerner straddles the line between partner and competitor
Cerner is digging into what it sees as a lucrative Medicare Advantage market leveraging a recently announced partnership with Lumeris. But Centene’s recent joint venture with Ascension—a Cerner health system—could put the vendor at odds with one of its…
Teladoc CEO: Medicare telehealth proposal paves the way for long-term expansion
Noting that the Medicare proposal to reimburse physicians came “earlier than we expected,” Teladoc CEO Jason Gorevic says the administration is backing a long-term expansion of telehealth coverage.
With a stunning Q2 performance, Molina is officially a comeback story
This time last year, Molina Healthcare had just dumped its CEO and CFO and was on its way to $512 million in losses. Now, the company has mounted a comeback, and it’s eyeing the ACA exchanges as its next target.
Hospitals see a $4.8B lift in final CMS payment rule that focuses price transparency, interoperability
The Centers for Medicare & Medicaid Services (CMS) has finalized a hospital payment rule that includes an additional $4.8 billion for inpatient services as well as several new requirements around price transparency and data sharing.
Trump administration finalizes expansion of short-term health plans
The Trump administration has finalized a rule to allow insurers to sell short-term limited duration health plans for up to 12 months, a controversial move that has been criticized by the industry.
Virginia’s new data sharing platform could be a peace offering in payer-provider battle to control ED utilization
On Tuesday, Virginia Gov. Ralph Northam announced the launch of the state’s Emergency Department Care Coordination program, designed to share ED data between 129 hospitals across the state to control utilization. A second phase scheduled for next year …
Insurers petition court to rehear risk-corridor case involving $12B in ACA payments
Six weeks after a devastating court ruling pulled the rug out from under a case involving $12 billion in the ACA’s risk-corridor program, Moda Health and Land of Lincoln are asking the Federal Court of Appeals to rehear it.
