Category: FierceHealthPayer

Trump administration faces uphill battle in convincing provider skeptics to back new drug pricing plan

The Trump administration’s plan to bring down prices in Medicare Part B has drawn skepticism, including from providers who helped sink a similar proposal from the Obama White House. 

Medicaid enrollment slowed in 2018, but spending remained the same

With the economy back on its feet, Medicaid enrollment calmed this past year, but drug costs, behavioral health and long-term care services drive the bulk of spending, according to new analyses from the Kaiser Family Foundation.

Universal Health Services officials ‘optimistic’ for resolution in DOJ investigation soon

Health system officials addressed the ongoing Department of Justice investigation and discussed the financial outlook for its behavioral health facilities.

Payer Roundup—North Carolina to begin Medicaid managed care; Anthem taps Google whiz for AI

Through a recently-approved §1115 waiver, North Carolina will begin transitioning its Medicaid population into managed care, with custom programs for certain populations. Plus, Anthem is bringing on Google’s former head of search products to work on AI.

Physicians frustrated by complexity and speed of alternative payment models, report says

New findings from the American Medical Association and the RAND Corporation say that physicians, especially those in small practices, feel APMs are becoming too complicated, and they’re not able to keep up with the whirlwind of regulatory changes surro…

Amazon, Walmart, Cigna among companies announcing commitment to opioid crisis as Trump signs new law

As President Donald Trump held a ceremony to sign a massive package aimed at combating the opioid crisis into law on Wednesday, the administration also announced commitments of support from large companies including Amazon, Cigna, CVS Health, Rite Aid,…

The challenge of designing new payment models for prescription drugs 

Prescription drug markets have yet to align with the drive for value-based care in the provider market, and plenty of hurdles stand in the way of that process, experts say. 

Oscar heads into ‘strong’ individual market looking to lure members with consumer-centric onboarding

By functioning like a tech company—in its use of digital tools and operationally—the startup insurer hopes to provide a simpler, more personalized experience for consumers. That starts with the company’s interactions during open enrollment, Sara Wajnbe…

HHS announces new payment model for mothers addicted to opioids

The Center for Medicare and Medicaid Innovation will partner with state Medicaid agencies to integrate a wide range of services for pregnant and postpartum women, HHS Secretary Alex Azar announced on Tuesday.

Trump administration expands health reimbursement arrangements for marketplace coverage

The Trump administration plans to release a proposed rule on Tuesday morning allowing businesses to provide employees with money to purchase health insurance on the individual marketplace, according to senior officials. The change is expected to add 7 …