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'Don't think you can turn into or develop a health plan on a dime'

'Don't think you can turn into or develop a health plan on a dime'

By Modern Healthcare  |  January 30, 2016

Mary Brainerd, CEO of HealthPartners, discusses her system's foray into insurance, the challenges faced by providers that want to make similar moves and her own experience in the healthcare system as a patient with breast cancer. She spoke with Modern Healthcare reporter Bob Herman.

AHIP starts early with Medicare Advantage political pressure

AHIP starts early with Medicare Advantage political pressure

By Bob Herman  |  January 28, 2016

America's Health Insurance Plans, the primary lobbyist for the health insurance industry, is funding a “seven-figure” ad campaign that targets Medicare Advantage and aims to put pressure on the Obama administration to stabilize funding for the private version of Medicare.

Q&A: Marilyn Tavenner on AHIP's way forward

Q&A: Marilyn Tavenner on AHIP's way forward

By Modern Healthcare  |  January 23, 2016

Former CMS chief Marilyn Tavenner discusses her move to head up America's Health Insurance Plans and the challenges faced by the group's members, which have struggled in the fledgling insurance marketplaces created under the ACA.

Tavenner slams CMS for Medicare Advantage underpayments

Tavenner slams CMS for Medicare Advantage underpayments

By Virgil Dickson  |  January 23, 2016

The CMS’ previous administrator, Marilyn Tavenner, criticized the agency after an analysis showed it has underpaid Medicare Advantage plans for the costs of treating individuals with chronic conditions.

CMS makes opting out of meaningful use easier

By Modern Healthcare  |  January 23, 2016

The CMS has made it easier for providers to opt out of meaningful use requirements in the federal electronic health record program. In December, a new federal law authorized the CMS to batch process hardship applications by categories instead of the case-by-case method previously used.

CMS bans Cigna from selling new Medicare Advantage plans

By Virgil Dickson  |  January 22, 2016

The CMS has banned Cigna from offering new Medicare Advantage plans after finding issues with the way the insurer handled appeals, grievances and its drug formulary. Investors don't believe the sanctions would affect the insurer's pending deal with Anthem.

Medicare's new ACO model preps hospitals to become insurers

Medicare's new ACO model preps hospitals to become insurers

By Bob Herman  |  January 16, 2016

The latest iteration of Medicare's accountable care experiment paves the way for more doctors and hospitals to evolve toward starting their own Medicare Advantage plans, stoking a trend that's already well underway.

MedPAC tweaks to Medicare Advantage rules could save up to $5 billion

By Virgil Dickson  |  January 14, 2016

MedPAC voted Thursday to request that Congress pass legislation letting the HHS secretary eliminate benchmark caps and “double bonuses” now given to Advantage plans. That proposal comes after a series of whistle-blower cases that allege providers and Advantage plans bilked the system.

Big insurer defections signal AHIP's fading clout

Big insurer defections signal AHIP's fading clout

By Bob Herman  |  January 09, 2016

Aetna's departure from AHIP months after UnitedHealth Group bolted is further evidence that the large national insurers are increasingly happy to fight their own battles on Capitol Hill, such as shepherding their pending mega-mergers and negotiating changes to the ACA marketplaces.

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