Advertisement
Actuaries want rates revised if subsidies end

Actuaries want rates revised if subsidies end

By Bob Herman  |  February 28, 2015

Actuaries are pressing HHS to allow health insurers to revise their rates for 2016 coverage if the U.S. Supreme Court invalidates the Affordable Care Act's premium subsidies in federal exchanges.

Guest commentary: Partnering with a med-mal insurer to improve care, cut costs

Guest commentary: Partnering with a med-mal insurer to improve care, cut costs

By Larry Smith and Nat Cross  |  February 25, 2015

The popular stereotype of the role played by medical malpractice insurers in the nation's healthcare system is not positive. And it's true that hospitals and their insurers can be wary and contentious partners, tied together by financial necessity and the stark realities of a litigious society. But...

Hospital prices drop for the first time

By Melanie Evans  |  February 21, 2015

Payers' efforts to drive down hospital prices may be succeeding. Prices that private and public health insurers paid to acute-care hospitals declined in January, compared with the same month a year ago, the first time they have dropped since the federal government began collecting these data.

CMS: Boost Medicare Advantage payments 1.1%

By Bob Herman  |  February 21, 2015

The CMS has proposed increasing health insurers' Medicare Advantage payment rates by 1.05% for 2016, a move that kicks off a 45-day dogfight in Washington before the rates are cemented.

Feds probe Humana's Medicare Advantage practices

Feds probe Humana's Medicare Advantage practices

By Bob Herman  |  February 21, 2015

The Department of Justice has asked health insurer Humana for more information about its Medicare Advantage risk-adjustment practices, based on a whistle-blower lawsuit from several years ago, Humana said last week in a regulatory filing.

Rate battle peaks as Advantage plans grow

Rate battle peaks as Advantage plans grow

By Bob Herman  |  February 20, 2015

Paula Ercolini is one of about 1.8 million seniors who are part of a Medicare Advantage advocacy group that is blitzing the airwaves and putting pressure on the Obama administration and Congress.

Q&A: 'Imagine if healthcare were priced to consumers'

Q&A: 'Imagine if healthcare were priced to consumers'

By Modern Healthcare  |  February 14, 2015

Mark Ganz, president and CEO of Cambia Health Solutions, a not-for-profit parent of 22 companies offering healthcare products and services, discusses how his companies are seeking to make healthcare more consumer-directed.

Lobbying peaks as rates for Medicare Advantage expected

Lobbying peaks as rates for Medicare Advantage expected

By Bob Herman  |  February 14, 2015

Health insurance lobbyists are sharpening their knives this week in preparation for the CMS' scheduled announcement of preliminary 2016 Medicare Advantage payment rates after the markets close Friday.

Co-op insurance plan finances should be watched closely

By Bob Herman  |  February 14, 2015

Many of the new consumer-governed, not-for-profit health plans launched thanks to the ACA were in shaky financial shape in their first nine months of operation and will need to be closely monitored, raising questions about the law's method of boosting insurance competition.

Practice Makes Perfect: Knowledge is power in payer negotiations

Practice Makes Perfect: Knowledge is power in payer negotiations

By Joan Hablutzel  |  February 13, 2015

Administrators and medical practice staff are knowledgeable about writing, analyzing and negotiating contracts with payers. While it's much a part of practice operations, there are still new strategies to employ when negotiating with a payer—or renegotiating with an existing payer—that...

Hard-to-find prices stop insured patients from comparison shopping

By Melanie Evans  |  February 03, 2015

What patients with health insurance spend out-of-pocket for a handful of common medical services varies greatly, according to a new analysis that suggests patients can benefit from shopping around but often don't because of the entrenched lack of price transparency in healthcare.

Advertisement
Modern Healthcare Daily

The top stories in healthcare business every day

The Modern Healthcare Daily News App provides you with registration-free access to the top trending healthcare business news. It's the only news you need each day.