News

GAO finds HealthCare.gov is 'high-risk'

HealthCare.gov may still have security holes, according to a report from the Government Accountablity Office. 

Insurers seek to shift more Rx costs to members

Payers have faced allegations of discriminating against patients with certain health conditions; a violation under the Affordable Care Act. But some insurers are finding ways around the provision by shifting more of the cost of prescriptions onto consumers.

 

Reimbursement system is broken, insurance CEO says

The health insurance payment system is broken and the Affordable Care Act, which was supposed to lower costs, is actually contributing to the problem, MVP Health Care CEO Denise Gonick, told the Albany Business Review

IOM wants insurers to pay docs for palliative care

If insurers pay doctors to discuss death and end-of-life care with their patients, this may significantly reduce unnecessary spending and lower healthcare costs, according to a recent report from the Institute of Medicine.

Insurers: Customer service, member retention is more than a marketing initiative

When it comes to purchasing and selling health plans, consumers and payers start the experience clock ticking at different times. For consumers, the experience begins the minute their insurer picks up the phone. That's not always the case for payers--but it should be, consumer engagement experts say. 

 

Insurers oppose Partners HealthCare's acquisition plan

Massachusetts health insurers filed complaints with Attorney General Martha Coakley's office Monday, claiming that Partners HealthCare's supposed acquisitions of three hospitals would raise costs for consumers, reports the Boston Globe.

Anthem Blue Cross teams with 7 hospitals to launch integrated care program

Anthem Blue Cross and seven hospital groups in the highly-competitive Los Angeles market announced today that they'll form a partnership to provide a high-quality, cost-effective care. 

Companies look to eliminate the payer 'middle-man,' partner directly with ACOs

Insurers be warned: Many corporate executives are mulling whether they can provide their employees with higher-quality and more cost-effective healthcare without going through an insurance company.

Medicare Advantage roundup: UnitedHealth, Humana, MVP Health Care make changes

There have been a lot of changes to Medicare Advantage plans of late--UnitedHealth dropped providers in Alabama, Humana lost a big provider contract and MVP Health Care is discontinuing two of its plans.

Big companies, insurers urge uptake in wellness programs

Aetna and the Blue Cross Blue Shield Association are joining forces with some of the biggest companies to urge the entire business community to embrace wellness programs as a way to lower healthcare costs and boost employee health.

115,000 could lose health coverage over missing immigration status documents

Nearly 115,000 individuals could lose their health coverage on October 1 because they failed to provide documents proving they are United States citizens or legal immigrants. 

Private exchanges gain ground in competitive health insurance marketplace

Private exchanges are shaping up to be a major player in the healthcare industry--they now cover more than 1.5 million people. Philadelphia-based Independence Blue Cross is the latest entry into the market sector.

UnitedHealth's price transparency tools help consumers choose high-quality docs

When consumers used UnitedHealth's price transparency tools, they were able to comparison shop for lower costs and search for high-quality providers, according to a new study of the insurer's myHealthcare Cost Estimator (myHCE). 

Humana, Anthem, UnitedHealth lead the pack in online keyword ad spend

Humana led all health insurers on online health insurance advertising spending, shelling out $4.2 million for paid search ads in the first six months of 2014. The data is based on a new report that examined Google AdWords activity for desktop and tablet searches of more than 6,000 health insurance-related keywords from January to June 2014.

Payer-provider collaborations seek to answer proton beam therapy questions

When it comes to high-priced clinical treatments with murky evidence of effectiveness, proton beam therapy takes the cake. As hospitals rake in the profits, payers are left with the bill for a treatment that can cost $30,000 more than other types of radiation therapies

States game Medicaid for millions

Many states avoid paying their share of Medicaid expenses, an issue the U.S. Department of Health and Human Services has known about for more than a decade, according to the Washington Post.

Aetna talks about closing CarePass, future mHealth plans

When Aetna announced it was shuttering its CarePass mobile platform by the end of the year, industry experts have been left wondering what caused the demise of CarePass and whether other insurers' mobile engagement initiatives could suffer a similar fate. To gain exclusive insight into Aetna's decision to close its CarePass mobile platform and learn where the company plans to take its mobile health strategy in the future, FierceHealthPayer spoke with Michael Palmer, Aetna's chief innovation & digital officer.

Midterm elections could impact Medicaid expansion

Five hotly contested governor races could have a big impact on Medicaid expansion. If the Democrats take Florida, Maine, Kansas, Wisconsin and Georgia, an additional 1.7 million people would likely become eligible for Medicaid coverage.

Insurers fight provider consolidation

As the trend toward hospital mergers and acquisitions continues, America's Health Insurance Plans is pushing back against consolidation, saying it jeopardizes insurers' attempts to move toward a value-based reimbursement system

New Apple Watch: Should insurers foot the bill for popular but untested tech?

In an exclusive interview with FierceHealthPayer,  Harry Greenspun, M.D., director of Deloitte's Center for Health Solutions, explains what technology like the new Apple watch means for payers.