Category Archive: FierceHealthPayer

Anthem agrees to $115M settlement over 2015 data breach

Anthem has agreed to pay $115 million to settle a class action lawsuit following a 2015 data breach that exposed nearly 80 million patient records. The settlement requires the insurer to pay for credit monitoring and devote specified amount of money to…

Nearly 1 in 4 Medicaid patients prescribed opioids in 2015

Express Scripts, a pharmacy benefits management firm that is one of the largest managers of Medicaid drug benefits in the country, analyzed data on 1.8 million opioid prescriptions given to 3.1 million Medicaid enrollees in 14 states. It found that 6% …

Study finds racial disparities in readmission rates for Medicare patients

New research suggests that Medicare Advantage plans may be linked to greater racial disparity in readmissions.

Employee engagement, soliciting feedback helps Humana boost its wellness program

Humana increased participation in its employee wellness program by engaging with staff members and including them in discussions about how to shape it in the future.

The impact of Medicaid expansion: More trips to the ER, but fewer patients are uninsured

Emergency room visits increased in states that expanded Medicaid coverage under the Affordable Care Act, but more of those patients had insurance, according to a new analysis. The study, published today in Annals of Emergency Medicine, found that after…

Medi-Cal patients flocking to ERs more than before ACA

From California Healthline: Medi-Cal patients are swamping California emergency rooms in greater numbers than they did before the Affordable Care Act took effect, despite predictions that the health law would ease the burden on ERs. Emergency room visits by people on Medi-Cal rose 75% over five years, from 800,000 in the first quarter of 2012 to 1.4 million in the last quarter of 2016, according to data recently released by the state’s Office of Statewide Health Planning and Development.

Physician frustration with prior authorizations only grows

Doctors are fed up with prior authorizations from health insurance companies, according to two physician organizations. The American Academy of Family Physicians said that frustration has reached an all-time high as it and the Medical Group Management …

AHIP 2017: Eric Topol runs through the cost-cutting technologies that fit in the palm of a patient’s hand

AUSTIN, Texas—Eric Topol, M.D., has performed a full-body scan of himself using a smartphone and a mobile ultrasound device. He imaged his carotid artery, his liver, his kidney … even his left foot. He calls it a full-body selfie and predicts that more folks will use these types of devices at home—no referral, doctor’s appointment or costly trip to the emergency room required.

How technology upgrades sparked a financial resurgence at two rural hospitals

Two rural hospitals in Oklahoma and South Dakota were facing financial uncertainty when each decided to take a leap of faith by upgrading technology and using data to expand specialty services. Thanks in part to broader use of telehealth and integrated…

Anthem exit from Ohio’s ACA exchanges adds urgency to GOP efforts to repeal and replace healthcare reform law

Anthem has announced it will pull out of the Affordable Care Act exchanges in Ohio, a move Senate Republicans say proves that the health insurance markets are set to collapse and makes repealing and replacing the healthcare reform law more urgent than ever.  

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