Category: FierceHealthPayer

More insurers expected to enter the ACA exchanges in 2019

Senior adviser to the executive VP and coverage expert Katherine Hempstead, who worked on a new online tool that allows users to track individual market entry for the 2019 plan year by state, county and carrier, says the data shows insurers are stickin…

Payer Roundup—CMS reports consumers dropping coverage; Mississippi edits work requirement proposal

Exchange consumers are dropping coverage over time, but it’s not as bad as last year. That news and other headlines from around the web.

Trump selects Kavanaugh for Supreme Court pick, raising plenty of questions about implications for healthcare

After President Trump announced his pick of Brett Kavanaugh for his Supreme Court pick, all eyes pointed to what it could mean for major healthcare decision including the Affordable Care Act and the future of abortion laws.

Azar says 340B changes are coming in bid to get a handle on drug prices

Putting politics aside, HHS Secretary Alex Azar spoke to a group of 340B hospital representatives on Monday. He said the program needs changes, but he also reiterated the administration’s commitment to lowering drug prices.

Trump administration: Drugmakers that hiked prices may create ‘tipping point’

HHS Secretary Alex Azar was speaking Monday at the summer conference for the 340B Coalition, which represents programs and providers that support the drug discount program. It came as President Trump threatened action against companies like Pfizer for …

Cerner sinks $266M into Lumeris as part of strategic partnership targeting Medicare Advantage plans

Cerner will become a minority owner in Lumeris’ parent company as part of a 10-year strategic partnership focused on value-based care payment arrangements, particularly in the Medicare Advantage space. The two companies plan to release a new joint offe…

Experts: Trump administration’s suspension likely won’t delay risk adjustment payments

During an event hosted by the American Enterprise Institute examining the future of the ACA, healthcare experts said they don’t expect insurers to experience a delay in risk adjustment payouts.

CMS suspends $10.4B in risk adjustment payments to insurers

Over the weekend, CMS announced it was freezing billions in risk adjustment payments to insurers on the ACA marketplace, citing a New Mexico court ruling from March. AHIP said the decision would create more market uncertainty and increase premiums.

Payer Roundup—CMS delays deadlines for new bundled payment model

The Centers for Medicare & Medicaid Services is pushing back the deadline to participate in the Trump administration’s new bundled payment program, and Vermont is planning to regulate the White House’s recently announced associated health plans.

Industry Voices—It’s time to move to ‘value 2.0’ in healthcare

Mark Linthicum, director of scientific communications at IVI, discusses the problems with measuring the “value” in value-based payment arrangements. He also has some recommendations for CMS.