Author's posts
Provider consolidation is causing premium hikes in rural areas, analysis says
A lack of competition among providers, fueled by consolidation, is largely causing the rural-urban disparity. But consolidation shows no signs of slowing down, leaving some wondering if states should take matters into their own hands.
Red or blue, both political parties have work to do on their 2020 healthcare platforms
In our partisan era, we know Republicans and Democrats rarely agree. But there’s also considerable fighting within each party about how to approach healthcare, and that has to change by 2020, NYU’s Shelly Glied and Stanford’s Lanhee Chen said on Friday.
Payer Roundup—Cigna offers up new mental and behavioral health apps; Anthem focused on growth
Cigna is offering its employers new apps that can help consumers improve their mental well-being and reduce their alcohol consumption. Plus, Anthem’s VP of commercial and specialty products anticipates growth across the board.
Big 8 health insurers rake in more than $7B in Q3, setting up strong finish to 2018
Most health insurance companies profited handsomely by the end of this past quarter. Aetna, Molina and UnitedHealth performed especially well, albeit for varying reasons.
CMS gives states permission to waive Medicaid’s IMD exclusion, expanding mental health treatment
In an announcement on Tuesday, Health and Human Services Secretary Alex Azar said the so-called institutions for mental diseases (IMD) exclusion has “unnecessarily restricted” access to critical mental healthcare for beneficiaries.
Jury pins Aetna with $25.5M verdict for denying cancer treatment
The insurer refused to cover “the best and only treatment” for an Oklahoma woman’s stage 4 cancer. With their verdict, jurors said it’s up to Aetna to fix the broken healthcare system.
Payer Roundup—Medicaid expansion a priority in Maine, likely in Kansas
Voters decided to expand Medicaid in Idaho, Nebraska and Utah via ballot initiatives last week. Gubernatorial elections in two other states have major implications for expansion as well.
HHS planning new bundled payment models with mandatory participation on the table
While both voluntary and mandatory bundled payment models have the potential to advance value-based care, mandating participation provides HHS the most information about what works, said Secretary Alex Azar.
CMS proposes additional oversight of ACA exchanges, including abortion coverage
The agency wants to prevent people who are enrolled in Medicare from also enrolling in exchange plans, and it also wants to bill consumers separately for the portion of premiums that would go toward abortion services.
Humana reports $901M in Q3 earnings, attributing growth to prevention
Making the most of technology and addressing social determinants of health improved the customer experience for members and cut costs, said CEO Bruce Broussard.
