In a turf war between hospitals and health insurers over physician practices, hospitals are winning by a long shot. But a slew of recent activity shows that insurers are clawing their way back.
Emergency department spending per member nearly doubled from 2009 to 2016 as the severity of ED visits and the prices associated with those visits increased, new data from the Health Care Cost Institute shows.
Brian Pieninck succeeds Chet Burrell, who announced his retirement from the Baltimore-based insurer in September last year.
Anthem's deal with Aspire Health marks another in a slew of provider purchases by insurers aiming to reduce costs by shifting care away from costly inpatient settings.
NYC Health & Hospitals and UnitedHealthcare are heading to arbitration over $11.5 million in denied inpatient medical claims. Most were for emergency care for patients covered by UnitedHealthcare's Medicaid and Medicare programs.
David Cordani doesn't view Cigna as merely a health insurer. The Bloomfield, Conn.-based company, he said, is in the business of delivering "health services." The proposed $54 billion purchase of Express Scripts falls in line with that, he argued.
Providers, advocacy groups and some policymakers are pressing for stronger enforcement of mental health parity laws. But congressional Republicans and Democrats disagree about giving the federal government more enforcement power.
The quarterly profit—the first Oscar has reported since launching five years ago—signals that the health insurer's strategy of creating narrow networks through partnerships with major brand-name hospital systems may be a winner.
Molina has been putting together a new team of experienced Medicaid executives to help turn the struggling insurance company around.
As insurers begin to file 2019 rates, two trends are emerging: Rate hikes will be steep and vary widely across states and plans, as regulators use different strategies to stabilize individual markets and promote affordability and choice.
Brian Griffin, the CEO of Anthem's new in-house pharmacy benefit manager, IngenioRx, has resigned to head up Diplomat Pharmacy, a specialty pharmacy services provider.
Clover Health, a Medicare Advantage insurer that uses data analytics to care for its members, will provide in-home primary care and genetic testing to its sickest senior patients.