Healthcare It News

APRIL 16, 2024

Payers will not only need to comply with the 2024 CMS Final Rule pertaining to materials and content, but they will need to go the extra mile because it affects star ratings, says Ernie Crawford, president and CEO of Crawford Technologies.

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Fierce Healthcare

DECEMBER 13, 2023

A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues (..)

Accountability 327

Accountability Medicare Hospitals 327

Fierce Healthcare

FEBRUARY 23, 2024

Online therapy company Talkspace is doubling down on its strategy to grow its business with payers and employers with a focus on providing services to teens and seniors. Online therapy company Talkspace is doubling down on its strategy to grow its business with payers and employers with a focus on providing services to teens and seniors.

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Fierce Healthcare

SEPTEMBER 13, 2023

Providers are under significant pressure as the COVID-19 pandemic effects wear on, so it shouldn't come as a surprise that they're pushing payers for more in contract negotiations. However, certain deals of late have gotten highly contentious—and gone public in a way that isn't typical for the industry.

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307

Fierce Healthcare

DECEMBER 15, 2023

More than two dozen healthcare payers and providers, including CVS, Premera Blue Cross and Mass General Brigham, are making voluntary safety, security and transparency commitments to the White Hous | More than two dozen healthcare payers and providers are making voluntary safety, security and transparency commitments to the White House regarding the (..)

Healthcare 323

Healthcare 323

Fierce Healthcare

APRIL 17, 2024

Below is a roundup of payer-centric news for the week of April 15, 2024. This week, Elevance Health acquires its competitor in New York, a Virginia health plan is under investigation and the OIG office looks into vertical consolidation.

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198

Fierce Healthcare

APRIL 5, 2024

Payer Roundup—Blue Cross Blue Shield Association lawsuit unfolds; Rightway raises $109M; Surescripts reportedly eyes sale ntong Fri, 04/05/2024 - 16:02

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261

Fierce Healthcare

JANUARY 18, 2024

Below is a round-up of payer-centric news for the week of Jan. 2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters.

Medicaid 287

Medicaid 287

Fierce Healthcare

SEPTEMBER 26, 2023

Digital health company Waltz Health is cracking into the payer market by inking its first partnership. Digital health company Waltz Health is cracking into the payer market by inking its first partnership.

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Fierce Healthcare

MARCH 28, 2024

Pelago, a virtual substance use disorder (SUD) clinic working with payers and employers, has clinched $58 million in a series C round. Pelago offers integrated SUD management for employers and payers, with specialized treatment for tobacco, alcohol and opioid use disorders.

Integration 170

Integration 170

Fierce Healthcare

JANUARY 25, 2024

Below is a round-up of payer-centric news for the week of Jan. 22, 2024 | This week, California health plans formed a coalition to address long-term PPE shortages, Mark Cuban's drug company announced a new partnership with Livinity, popularity rises for Colorado's public option plans and more.

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Fierce Healthcare

JANUARY 12, 2024

While market pressures have often left payers and providers at odds in contract negotiations, leaders at Trinity Health and Anthem Blue Cross said that things don't always have to be this way. | The two announced Thursday that they had reached an agreement to extend their network agreement for multiple years.

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Fierce Healthcare

DECEMBER 18, 2023

Payers need to properly adapt to changes made to the Medicare Advantage star ratings program or risk financial repercussions, industry experts told Fierce Healthcare. Payers are being urged to prioritize health equity considerations more than ever before to improve their Medicare Advantage star ratings scores.

Medicare 296

Medicare Healthcare 296

Health Care Dive

JANUARY 26, 2023

Medicaid eligibility checks beginning in April will likely curb hospital revenue and enrollment growth for payers, Moody's Investors Service said in a report.

Medicaid 301

Medicaid Hospitals 301

Fierce Healthcare

APRIL 19, 2024

Payers face a multifaceted challenge of managing rising healthcare costs while also meeting the heightened expectations of consumers who expect medical interactions to be as personalized and conven | Third-party analyses recently commissioned by The Clinic by Cleveland Clinic showed medical cost savings from, and high consumer interest in, virtual (..)

Healthcare 130

Healthcare 130

Fierce Healthcare

SEPTEMBER 20, 2023

Providers and payers, meanwhile, didn't see eye to eye on which industry camp is treated unfairly under the current regulations outlining billing dispute arbitration.

Regulations 336

Regulations 336

Health Care Dive

MARCH 15, 2022

CMS hasn't been enforcing stipulations that payers share patient data with competitors set out in information blocking regulations finalized two years ago. But that could change soon with a new rule.

Regulations 311

Regulations 311

Fierce Healthcare

SEPTEMBER 17, 2021

CMS delays enforcement of key interoperability requirement of payer-to-payer data exchange. Fri, 09/17/2021 - 16:30.

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Fierce Healthcare

JANUARY 30, 2024

Payer Roundup–Molina Healthcare strengthens partnership with BeMe Health; North Carolina health plan limits GLP-1 coverage ntong Tue, 01/30/2024 - 16:37

Healthcare 274

Healthcare 274

Fierce Healthcare

AUGUST 11, 2023

While major payers issued warnings to investors ahead of second-quarter earnings about rising utilization rates, patients returning to deferred services did not prevent these companies from turning | While major payers issued warnings to investors ahead of second-quarter earnings about rising utilization rates, patients returning to deferred services (..)

Prevention 244

Prevention 244

Health Care Dive

DECEMBER 7, 2022

Regulators want payers to issue coverage decisions within 72 hours for urgent prior authorization requests — but the final turnaround time could be even shorter.

Regulations 318

Regulations 318

Fierce Healthcare

SEPTEMBER 26, 2023

Payers, providers are cautiously optimistic about their value-based care efforts. Here's how their sentiments differ agliadkovskaya Tue, 09/26/2023 - 14:22

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305

Health Care Dive

JANUARY 11, 2023

Providers are likely to clash with payers over rate hikes after a year of intense cost pressures.

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326

Fierce Healthcare

FEBRUARY 22, 2024

Below is a roundup of payer-centric news for the week of Feb.19, This week, voters said they are worried about insurance premium costs in a new poll, Cigna invests nearly $10 million in 9amHealth, Waltz Health enters the Medicare market and more.

Medicare 146

Medicare 146

Fierce Healthcare

MAY 11, 2023

Payers uniquely positioned to enhance health equity, United Hospital Fund report says agliadkovskaya Thu, 05/11/2023 - 10:07

Hospitals 329

Hospitals 329

Fierce Healthcare

DECEMBER 5, 2023

Fierce Healthcare sits down with healthcare executives at Fierce Health Payer Summit 2023. Fierce Healthcare sits down with healthcare executives at Fierce Health Payer Summit 2023. Payer leaders came together at the event to unpack the evolving landscape, providing a deep dive into the most important issues facing the industry.

Healthcare 130

Healthcare 130

Fierce Healthcare

JULY 24, 2023

While payers are facing headwinds going into the latter part of this year, the ongoing financial impacts of healthcare's labor shortage will be felt in the hospital sector far longer, according to | While payers are facing headwinds going into the latter part of this year, the ongoing financial impacts of healthcare's labor shortage will (..)

Medicaid 246

Medicaid Hospitals Healthcare 246

Fierce Healthcare

MAY 19, 2023

Commercial payers frequently delayed paying out providers' claims in Q1, report finds dmuoio Fri, 05/19/2023 - 15:44

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333

Fierce Healthcare

DECEMBER 1, 2023

But here's how the payers could eke out a win pminemyer Fri, 12/01/2023 - 13:55 Analysts say a Cigna-Humana merger is likely to face major antitrust opposition.

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344

Fierce Healthcare

JUNE 29, 2023

Healthcare costs will balloon 7% next year, as payers hammer out new contracts with providers, the labor shortage stretches on and drug prices continue to increase, according to a new

Healthcare 263

Healthcare 263

Fierce Healthcare

MAY 8, 2023

UnitedHealth extends its hot streak as the most profitable payer in Q1 pminemyer Mon, 05/08/2023 - 13:28

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349

Fierce Healthcare

APRIL 18, 2023

Report: Hospitals, payers making strides on price transparency compliance dmuoio Tue, 04/18/2023 - 09:49

Hospitals 287

Hospitals 287

Fierce Healthcare

FEBRUARY 6, 2024

As the company deepens its relationships with payers in Michigan and Minnesota to serve wider populations, achieving B Corp certification alongside its existing public benefit corporation status reinforces Homeward's commitment to the rural communities it works in, executives said.

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193

Fierce Healthcare

FEBRUARY 15, 2024

Below is a roundup of payer-centric news for the week of Feb. This week, Cigna says it has repurchased billions more in stock, Centene subsidiaries focus on food and maternal health partnerships and CVS' Aetna is joining forces with Monogram Health to provide at-home kidney care for MA members.

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Etactics

APRIL 26, 2024

On average, a healthcare provider has between 16 and 20 payer contracts. There’s no right answer, but understanding what a payer agreement is will show the significance of that average number. A payer commonly looks like insurance companies, government programs, and employers. There all different types of payers.

Healthcare Providers 52

Healthcare Providers Quality of Care Medical Services Healthcare 52

Health Care Dive

APRIL 19, 2022

As a last resort, the No Surprises Act allows payers and providers to resolve payment disputes using arbitration. The online site that initiates the process is now open.

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318

Fierce Healthcare

SEPTEMBER 20, 2023

Veda, a data automation startup serving payers, has partnered with OutCare Health to help patients and payers identify queer-affirming providers. Data automation company Veda will ingest that information and offer it to payer clients. OutCare Health is known for its OutList, an extensive directory of LBGTQ+ affirming providers.

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