Category: FierceHealthPayer

CMS allows Medicare Advantage plans to negotiate Part B drug prices, implement step therapy

In a significant move meant to foster competition, allowing Medicare Advantage plans to negotiate Part B drug prices will generate cost savings that they then can pass on to consumers, the agency says.

Blue Cross Blue Shield to offer discounted Fitbits to members through new partnership

The insurance association hopes the move will “help consumers create and maintain healthy habits,” despite studies that suggest owning a fitness device will not improve one’s health.

This is the ‘disruption’ large employers are hoping Amazon brings to healthcare

National Business Group on Health CEO and President Brian Marcotte elaborated on what large employers are looking for out of Silicon Valley as they weighed in on their expectations for healthcare benefits in 2019.

Large employers playing more ‘activist’ role in health costs, dialing back push to high-deductible plans

The latest survey from the National Business Group on Health found large employers are playing a more “activist” role in healthcare, doubling down on narrow network strategies even as fewer of them only offered consumer-directed health plans.

Study: Bundled payments drive hospitals to reduce referrals to SNFs, improve coordination

Bundled payments are pushing hospitals to cut back on discharges to skilled nursing facilities, according to a new study. This could have significant implications for postacute providers, the researchers say.

Study finds insurance monopolies are primary driver of higher ACA premiums

Among rating areas in states with federally facilitated marketplaces, the number of insurers was a more accurate predictor of premiums than enrollee health or provider characteristics.

Henry Ford Hospital, GM ink direct contract for employee coverage

The Detroit legacy institutions announced the agreement to create GM’s new “ConnectedCare” plan option on Monday that would bypass traditional insurers and allow the health system to deliver both healthcare management and wellness services to salaried …

Report: Wisdom tooth surgery increases risk for long-term use of opioids

Looking at an national database of employer-based insurance plans, researchers warn opioid drug prescriptions associated with the common dental procedure may be leading to long-term use among young people.

In Medicare Advantage market, Cerner straddles the line between partner and competitor

Cerner is digging into what it sees as a lucrative Medicare Advantage market leveraging a recently announced partnership with Lumeris. But Centene’s recent joint venture with Ascension—a Cerner health system—could put the vendor at odds with one of its…

Humana sues dozens of generic drug manufacturers for price-fixing scheme

At conferences, over dinner, via text, and more, the companies colluded to increase the price of drugs for common conditions as much as 8,000%, the insurer’s complaint says.