Category Archive: FierceHealthPayer

HHS taps former CareFirst Blue Cross Blue Shield executive as senior drug pricing adviser

The Department of Health and Human Services has named a new adviser to oversee its drug pricing initiatives. 

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…

The outlook for nonprofit hospitals in 2019 is bad—but it’s not that bad

New reports from the two top rating agencies—Moody’s Investors Services and Fitch Ratings—offer a gloomy outlook for 2019 as nonprofit hospitals grapple with a tough reimbursement environment and weak inpatient volumes. But here’s why the sector is sti…

UPMC, Highmark breakup making it hard to do enrollment for seniors

This week marks the end of the enrollment period for Medicare Advantage recipients in Pennsylvania. But this sign-up season has been a bit of a trick for seniors in the western part of the state stuck in the middle of the breakup between the region’s l…

AHA, AAMC sue Trump administration over site-neutral payment rule

The Centers for Medicare and Medicaid Services which will gradually institute site-neutral payments in the Medicare program over the next two years. In a suit filed in the U.S. District Court for the District of Columbia, the American Hospital Associat…

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.

Federal watchdog: Nearly half of Medicare patients in long-term-care hospitals experienced harm

Nearly half of Medicare patients in long-term-care facilities have experienced some type of harm as the result of their care, endangering their health and increasing Medicare costs, according to a report from a government watchdog.

Medicare Advantage provider directories are riddled with errors. They’re not the only ones

Almost half of online Medicare Advantage directories contained incorrect or out-of-date information, CMS found in a recent investigation.

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.

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