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Patient, provider groups urge CMS to reinstate risk adjustment payments
The AMA, AHA and the Federation of American Hospitals were among the 28 groups that say CMS’ freeze on risk adjustment payments will cause premium hikes that prevent many people from obtaining coverage and limit access to medical care.
Patient, provider groups urge CMS to reinstate risk adjustment payments
The AMA, AHA and the Federation of American Hospitals were among the 28 groups that say CMS’ freeze on risk adjustment payments will cause premium hikes that prevent many people from obtaining coverage and limit access to medical care.
House Democrats say GOP’s ACA repeal efforts could scale back fraud prevention tools
Critical reporting and oversight provisions contained within the ACA would be lost if repeal efforts succeed, argued two Pacific Northwest representatives on the House Ways and Means Oversight Subcommittee.
Payer Roundup—Cigna, Express Scripts schedule merger vote; physician groups back risk adjustment payments
Shareholders of Cigna and Express Scripts will vote on the proposed merger in August that the companies say will create “a blueprint for integrated and personalized healthcare.” Meanwhile, six major physician organizations call for a reversal of risk …
Seeking clarity on racial disparities, Democrats ask insurers about maternal health coverage
More than 30 members of Congress signed letters to 15 major health insurers asking if and how their plans are working to reduce racial disparities in maternal mortality.
Medicare Advantage beats fee-for-service in utilization, outcomes
A new analysis from Avalere shows Medicare Advantage patients have fewer inpatient stays, ER visits and avoidable hospitalizations than fee-for-service beneficiaries, despite higher rates of social and economic risk factors.
Humana, private equity firms finalize $1.4B Curo acquisition
Combined with Kindred at Home, the acquisition will create the country’s largest hospice provider, of which Humana will own 40%.
House subcommittee debates need for 340B oversight amid host of new bills
A GAO report that concluded HRSA has failed to audit 340B sufficiently generated strong sentiments on both sides of the aisle as lawmakers grappled with how to provide more oversight to the program.
More insurers expected to enter the ACA exchanges in 2019
Senior adviser to the executive VP and coverage expert Katherine Hempstead, who worked on a new online tool that allows users to track individual market entry for the 2019 plan year by state, county and carrier, says the data shows insurers are stickin…
Payer Roundup—CMS reports consumers dropping coverage; Mississippi edits work requirement proposal
Exchange consumers are dropping coverage over time, but it’s not as bad as last year. That news and other headlines from around the web.
