Author's posts
Payers see consumerism and data analytics as top priorities in 2019. Most aren’t prepared to deliver
Value-based care initiatives will make smart use of data and customer satisfaction more important than ever next year, according to a new survey from consulting firm North Highland. However, most payers aren’t yet sure how they can distinguish themsel…
AHIP, CMS, NQF formalize collaborative to align quality measures across payers
In this public-private partnership, the organizations develop “parsimonious” sets of measures that payers of all kinds can use to create their own quality metrics.
Millions of citizen children could lose coverage due to public charge rule, study says
A new analysis from the Urban Institute says many immigrant families could drop their citizen children’s Medicaid and CHIP coverage out of fear due to the proposed public charge rule, reversing massive coverage gains.
With new legislators and governors, reinsurance programs have a bright future
A new analysis from Georgetown University discusses the many benefits of reinsurance for states, consumers, and insurers, and its authors say fresh faces in Congress and at the state level could expand such programs in 2019.
CVS-Aetna merger hits a snag as federal judge asks DOJ for more information
Until the Department of Justice explains why divesting Aetna’s Part D business now is in the public’s interest, Richard J. Leon says CVS and Aetna must remain separate.
New Medicare marketing guidelines raise the specter of past predatory sales tactics
The need for Medicare marketing regulations was crystal-clear 10 years ago. But a slew of changes to CMS’ Medicare marketing guidelines this year expanded what plans can do at educational events, in providers’ offices and more. Do these revisions creat…
New ACA innovation waiver policy brings major changes to state marketplace coverage
Fighting back against allegations that the administration is trying to sabotage the ACA, CMS Administrator Seema Verma said the new policy allows states to promote “consumer engagement, personal freedom and choice, spending smarter, price transparency,…
Medicaid demonstrations aren’t properly evaluated. Randomized trials could fix that
Section 1115 waivers are meant to be experiments that allow states to test coverage approaches that don’t meet federal program rules. However, most of their evaluations are not rigorously studied, argues a new commentary in the New England Journal of M…
Payer Roundup—High deductibles force diabetics to delay care; Florida adds CVS, Walgreens to opioid suit
People with diabetes are more likely to delay care if they have a high-deductible health plan, a new study says. Meanwhile, Florida’s AG added CVS and Walgreens to a long list of defendants in its suit over the opioid crisis.
Health tech collaborative hopes to bring valuable solutions to the vulnerable
Medicaid beneficiaries stand to benefit most from the latest health technology, but tech startups often pass them by in favor of seemingly more-lucrative payer partnerships. HealthTech4Medicaid wants to change that.
