Category: FierceMarkets

After weeks of vocal opposition, Carl Icahn halts fight against Cigna-Express Scripts deal

Prominent investor Carl Icahn justified his retreat from opposing the deal by pointing to recommendations from Institutional Shareholder Services and Glass Lewis.

As CMS retools its advanced payment models, providers still grapple with the tech requirements

As providers gear up to participate in CMS’ revamped payment models, one major hurdle stands in the way for many: technology. Despite investments in better electronic health records and other technological upgrades, plenty of the work and data remains …

Google parent Alphabet invests $375M in Oscar Health

Google has 14 years on Oscar, but both companies focus on reaching consumers in a technologically advanced, disruptive way.

DOJ expands Medicare Fraud Strike Force to Newark and Philadelphia

The Justice Department selected the cities for the Strike Force’s newest division due to the prominence of fraud, including illegal opioid distribution, in the region.

CMS’ ACO proposal resurfaces discord over pace of risk-based models

Although some ACOs may leave the program, the goal should be quality over quantity, says former Obama health IT official Farzad Mostashari. But NAACOs says Track 1 ACOs need more time to get their bearings.

The big 8 insurers made $16.6B in the first half of 2018. Here’s how they stack up

The first half of 2018 is in the books for insurers, and the field looks substantially different from last year. Most notably, Aetna’s net income jumped over 100%, Humana took a large hit from last year’s earnings and Molina made a small but notable co…

Industry Voices—We need ‘activist’ employers like Amazon to change healthcare as we know it

Waking up to the fact that they are paying for 50% of healthcare spending, employers like Amazon, JPMorgan Chase and Berkshire Hathaway are beginning to take on incumbents—insurance companies, hospitals, existing health systems and specialty care—by co…

CMS pushes ACOs to take on more risk with Medicare Shared Savings Program overhaul

A long-awaited rule from CMS would shorten the time frame that ACOs are allowed to be in an upside-only risk model to two years, a move that is likely to drive providers out of the program.

Azar: New HHS guidance aimed at curbing drug companies’ ‘abusive behavior’ in Medicaid

HHS has issued guidance aimed at blocking drug companies from manipulating a loophole in Medicaid’s payment policies that they can use to avoid paying out full rebates for certain medications.

CMS issues proposed rule justifying risk adjustment methodology

CMS’ newest explanation is the latest chapter in a months-long saga that started with a federal court ruling vacating the methodology in February.