News

Aetna, Weill Cornell Physicians establish accountable care agreement

In order to provide better access to care to nearly 9,000 residents in New York, Aetna announced on Tuesday its plan to team up with Weill Cornell Physicians, Cornell University's physician group, to establish a new accountable care agreement.

Kaiser, Group Health Incorporated pay multi-million dollar penalties

Certain top-name insurers are in the spotlight for having to pay some hefty penalties.

American healthcare: more for less?

A new trend in healthcare is underway in America, writes Vox's Sarah Kliff in her latest analysis. She's calling it "the get more, pay less" era.

Report: Exchanges will transform the health insurance business

As companies try to lower their health-related costs, they're moving away from providing benefits directly to their employees and instead pushing them to be more responsible for their own health insurance. That trend will fuel more growth in health insurance exchanges over the next 10 years, dramatically changing the health insurance business, according to a new report from PwC's Health Research Institute.

WellPoint, Blues plans big winners among exchange shoppers

WellPoint and many Blue Cross Blue Shield plans took an aggressive approach to participating in the health insurance exchanges--and it paid off. In 12 of the 15 states with exchange information available, WellPoint and Blues plans dominated the marketplaces last year, according to a new study from Avalere Health.

Prediction: Uncertainties, complications will plague upcoming ACA enrollment

This fall's ACA open enrollment period will suffer another wave of woes, one expert predicts. 

Uninsured rate for children remains at standstill

Even though children's participation in Medicaid or the Children's Health Insurance Program is higher than adults' participation in Medicaid, the uninsured rate for children has yet to change since implementation of the Affordable Care Act, according to a recent Urban Institute survey.

Cigna rebrands to emphasize community, expand reach in international markets

Cigna has rebranded itself with a new marketing campaign, shifting away from its individual-focused approach and moving toward a more comprehensive approach for both individuals and employer-based members.With its new "Together, all the way" tagline, Cigna hopes to create a sense of community and show how it is working with and advocating for them.

Humana bets on 'lifestyle medicine' to help reduce chronic conditions

Humana is investing in "lifestyle medicine"--an approach that aims to reduce chronic conditions by emphasizing healthful eating, exercise and community support in an effort to address the fact that more than 50 percent of healthcare dollars are associated with lifestyle conditions.

Va. Gov. McAuliffe shares Medicaid-alternative plan

Virginia Governor Terry McAuliffe (D) shared his Medicaid-alternative plan Monday, reports the Washington Post.

Rural Americans pose challenges for HIX enrollment

Enrolling rural Americans in health insurance will be one of the biggest problems insurers face during this fall enrollment period, reports Kaiser Health News

Good news for payers in a consumer-focused industry

Consumerization is in full swing throughout the entire healthcare industry. And as the transition from fee-for-service to value-based payment continues, high deductible plans slam providers with a negative credit outlook.

But for payers, the credit outlook is a bit more stable, despite some added risk, reports Healthcare Payer News.

Michigan Blues would pay $30M to resolve 'most favored nation' lawsuit

Blue Cross Blue Shield of Michigan is willing to fork out $29.9 million to resolve a consolidated lawsuit that claims the insurer used "most favored nation" clauses in its provider contracts, reported Crain's Detroit Business.

Narrow networks lower spending by a third, research finds

Although narrow networks aren't popular among providers and some states are even urging insurers to widen their provider lists, narrow networks can help lower healthcare costs by reducing patient spending by as much as a third, according to a new paper from the National Bureau of Economic Research.

HHS announces $60M in HIX navigator grants

Health and Human Services Secretary Sylvia M. Burwell today announced $60 million grant awards to 90 navigator organizations in states with federally-facilitated and state partnership health insurance marketplaces.  

Oregon's innovative way to do more with less Medicaid funding

The Affordable Care Act is changing how Medicaid funding works--money is increasingly tied to outcomes, rather than pegged to tests and procedures, according to a story published in the Milwaukee-Wisconsin Journal Sentinel.

Burwell takes initiative to ensure smooth enrollment period

The new U.S. Department of Health and Human (HHS) Secretary Sylvia Mathews Burwell appears to be pulling out all the stops to ensure a smoothly-operated second open enrollment period, set to begin on Nov. 15, reports The Hill.

Why ACA guidelines could harm success of wellness programs

A successful wellness program not only boosts employees' health and lowers costs, but also provides employees with incentives and perks. That's why more employers are teaming up with insurers to create effective wellness programs that focus on improvements, no matter how small.

UnitedHealth puts robust price transparency tools in consumers' hands

As health insurers continue their quest of achieving consumer engagement, many believe that offering price transparency tools is a key factor in achieving that goal. And UnitedHealth is taking those tools one step further by providing very specific cost estimates to their members. That means UnitedHealth members can get an extremely accurate price for total service cost, out-of-pocket expenses, co-payments and any outstanding deductibles.

To learn more about how UnitedHealth is leading the charge on price transparency, FierceHealthPayer spoke with Victoria "Tory" Bogatyrenko, UnitedHealth's national vice president for product, innovation and marketing.

For the time being, ACA off the hook for another Supreme Court ruling

A District of Columbia Court of Appeals Thursday agreed to rehear Halbig v. Burwell, a case charging that the federal government lacks the authority to provide consumers tax credits in health insurance exchanges not run by states