Category: FierceHealthPayer

CMS expands flexibility for state ACA innovation waivers

Administrator Seema Verma says allowing states to “fundamentally restructure” their individual markets and shift consumers to short-term and association health plans won’t hurt people with pre-existing conditions, but some policy analysts aren’t so sur…

Report: More providers adopting value-based payment models, but plenty still hesitate to take on risk

The number of payments tied to value-based models continues to grow, but there’s more work to be done to drive providers to take on risk, according to a new report. 

Kennedy Forum launches campaign against addiction, mental health care insurance denials

Calling the campaign “Don’t deny me,” former congressman Patrick Kennedy said he is trying to create a movement of patients pushing back against insurance denials for mental health and addiction care that should be covered under the decade-old parity l…

Healthcare.gov hit with data breach impacting 75,000 people

The federally run health insurance marketplace has been hit with a data breach impacting 75,000 individuals, the Centers for Medicare & Medicaid Services (CMS) disclosed on Friday. 

5 ways hospitals can mitigate the risks from a growing uncompensated care burden

Hospitals’ uncompensated care burden is likely to rise following the repeal of the ACA’s individual mandate, but there are steps providers can take to mitigate the challenges and risks associated with that trend, according to a new report. 

Medicaid managed care plans are making a foray into housing—but they can do more

In addition to medical care, UPMC and Kaiser Permanente are coordinating social services for their Medicaid managed care members experiencing or at risk of homelessness. But much more needs to be done.

To garner support for Medicaid, adopt ‘the Virginia way,’ says Gov. Ralph Northam

To expand Medicaid, the Virginia governor made an effort to ensure state legislators knew how their constituents would benefit. Evidence shows this is crucial.

Consumer-facing Medicare plan tools are inaccessible and inaccurate, experts say

Medicare Plan Finder frustrates many seniors, and there’s a lot of confusion over what star ratings mean, said multiple speakers at AHIP’s National Conference on Medicare.

Moody’s: Children’s hospitals outperform adult hospitals even as expenses rise

A new report from Moody’s Investors Services said children’s hospitals in the U.S. will continue to hold their financial advantage about 3-4 percentage points over adult hospitals over the next year due, in part, to strong patient demand and limited co…

‘Medicare-for-all’ compounds Medicare’s current problems, Verma says

Echoing her boss’s op-ed last week, Centers for Medicare & Medicaid Services Administrator Seema Verma devoted an unusually long time in one speech to why a popular progressive proposal would not work.