News

Treating and preventing opioid abuse saves money in the long run

Rising rates of prescription painkiller addiction have led to spikes in claims for drug abuse treatment and renewed emphasis on prevention, according to Healthcare Payer News.

Freelancers Union to stop providing healthcare to New Yorkers

New York-based Freelancers Union will stop providing healthcare coverage to nearly 25,000 of its members, reports the New York Times

Start up, CO-OP insurers are expanding into new markets

The competition continues to heat up within the insurance industry and the health insurance exchanges as start-up companies and consumer oriented and operated plans (CO-OPs) are doing so well that they're expanding into new markets.

40% of provider reimbursements are for value-based care

Demonstrating a dramatic move toward value-based payment, 40 percent of insurers' reimbursements to providers were for value-based care that improve quality and reduce waste--an increase of 29 percent from 2013, according to a new report from Catalyst for Payment Reform.

Federal judge rules against ACA subsidies

A federal judge in Oklahoma ruled Tuesday that Affordable Care Act federal subsidies cannot be issued to residents living in states that do not run their own exchanges.

Mount Sinai to join Empire BlueCross BlueShield

The Mount Sinai Health System announced today its plans to team up with Empire BlueCross BlueShield and join Empire's Pathway Network. 

Kaiser Permanente leaders share success strategies and advice

Kaiser Permanente chairman Bernard Tyson recently interviewed with Forbes about what's been called the "Kaiserfication" of healthcare, or rather, attempts by others to replicate Kaiser's success as an integrated hospital, physician and insurance organization that saw $53 billion in revenues last year.

4 signs the ACA is working

Tomorrow is the one year anniversary of HealthCare.gov's launch, and the debate regarding the healthcare reform law's popularity and effectiveness continues. An article in the New Republic said despite the controversy, it's important to look at the end result. It outlines four ways that prove the Affordable Care Act is working. 

Poll: Consumers aren't that interested in exchange plans

Insurers already worried about the second enrollment period for health insurance exchanges received a piece of bad news--just 29 percent of consumers said they will shop for new coverage on health insurance exchanges, according to a recent poll from Morning Consult.

Should insurers treat e-cigarettes like traditional tobacco products?

As e-cigarettes quickly gain popularity--more than 20 million people tried smoking one sometime in 2013--insurers are left without guidance or precedence on how to determine whether they should raise premiums for members who smoke e-cigarettes, reported the St. Louis Post-Dispatch.

Aetna, Hartford HealthCare team up to form accountable care arrangements

Aetna and Hartford HealthCare announced today a new collaboration that will focus on value-based, accountable care arrangements in Connecticut, set to begin on January 1, 2015. 

Feds, payers and states brace for ACA open enrollment

The second enrollment period for coverage made possible by the Affordable Care Act is approaching fast, and this brings two major challenges for states, insurers and the Obama administration: How do marketplaces retain enrollees while bringing respectable numbers of new people into the tent?  

Report: Medicaid enrollees experience limited access to care

State standards for access to care for those enrolled in Medicaid managed care programs varies greatly, according to a new report from the Office of the Inspector General.

More plans will exclude hospital benefits, compete on exchanges

Adding to the competition among insurers selling their plans on health insurance exchanges are new policies that exclude all hospital benefits.

Highmark could be the industry's next trendsetter

Some of Highmark's trendsetting actions have put the Pittsburgh-based insurer in the national spotlight this year.

Republican states interested in Medicaid expansion

States slowly are jumping on board to expand Medicaid, including several led by Republican lawmakers, reports Reuters. 

How to build a successful bundled payment program

As the health insurance industry continues its shift toward a value-based reimbursement system, more payers are experiencing with bundled payments. Though still relatively experiential, the model "has probably the most promise," Andréa Caballero, program director for Catalyst for Payment Reform, told FierceHealthPayer in an exclusive interview.

Docs leery of sharing risk with payers in value-based reimbursement

Physician distrust of payers presents a significant impediment to creating value-based reimbursement programs, according to a new survey from global business advisory firm FTI Consulting. In fact, 41 percent of physicians who do not participate in a value-based relationship point to distrust of payers as the major reason, according to a new survey. 

Survey: Consumers don't trust insurers, employers as health source

Many wellness programs could be doomed to fail based on a recent survey finding that most consumers don't trust their insurers or employers as a source of health and wellness.