Category: FierceHealthPayer

Governors’ seats turn blue in Wisconsin and Kansas with Medicaid expansion on the line

At the state level, Democrats won upsets in several red-leaning gubernatorial races, notably in Kansas and Wisconsin. But given that statehouses there are still largely controlled by Republicans, the possibilities for Medicaid expansion may be slimmer …

HHS set to implement long-delayed 340B final rule in January

HHS is planning an about-face on the long-delayed rule that would set price ceilings and monetary penalties in the 340B program, moving up its start date by several months.

With CMS’ new physician fee schedule on the way, 2018 could be a ‘turning point’ for telemedicine

WASHINGTON, D.C.—Even with new telehealth applications popping up every day, the central questions for doctors remain: Does it work, will I get sued and can I get paid? Advocates hope the CMS’ new physician fee schedule, expected to be finalized this w…

Envision doubles down on marketing push to rejoin UnitedHealthcare’s network

On the heels of a marketing blitz deflecting blame for surprise billing, physician staffing firm Envision is targeting employers and providers in another push to get back into UnitedHealthcare’s network.

Can providers help patients by partnering with pharma on digital health? Geisinger says yes

Geisinger Health System has launched several collaborations with large drug companies over the last year. Amid the search for value-based care’s silver bullet, the provider insists these unusual partnerships can improve patient outcomes and lower costs.

Can providers help patients by partnering with pharma on digital health? Geisinger says yes

Geisinger Health System has launched several collaborations with large drug companies over the last year. Amid the search for value-based care’s silver bullet, the provider insists these unusual partnerships can improve patient outcomes and lower costs.

Who’s calling the shots? Doctors worry about insurers overriding their treatment decisions

A new survey of doctors found that health plans are increasingly overriding the treatment decisions they make for their patients.

With major acquisitions in the books, WellCare looks to drive growth with partnerships

By working with local agencies, provider organizations, and more, WellCare can build on its third-quarter successes and deliver higher-quality products, said Ken Burdick on the company’s latest earnings call.

Private healthcare exchanges would better meet consumer needs, report says

While the current public exchanges have all the hallmarks of a monopoly, a series of private exchanges would compete to meet consumer demands, says the Council for Affordable Health Coverage.

CMS proposed rule expands telehealth for Medicare Advantage plans, beefs up payment audits

A rule proposed late on Friday would enact several provisions of the Bipartisan Budget Act, including one that would allow MA plans to offer more telehealth benefits than traditional Medicare.