Fierce Healthcare

JANUARY 22, 2024

The Biden administration’s healthcare regulators released new guidances, informational resources and other actions that reinforce payers and hospitals’ federal obligations surrounding reproductive | New letters and instructional materials out of HHS come amid reported contraception coverage barriers and escalating legal challenges over emergency abortion (..)

Hospitals 110

Hospitals 110

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

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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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 (..)

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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

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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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 (..)

Hospitals 131

Hospitals 131

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.

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STAT

NOVEMBER 13, 2023

The large physicians’ lobbying group voted to pass a resolution at the association’s interim meeting Monday saying it will “urge all payers to ensure coverage parity for evidence-based treatment of obesity, including FDA- approved medications without exclusions or additional carve-outs.”

Insurance 144

Insurance FDA 144

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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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.

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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.

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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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Pharmacy Times

FEBRUARY 29, 2024

Pharmacy's position at the intersection of the care team gives it a unique ability to connect providers, payers, and pharmaceutical manufacturers, and support patients to maximize their health outcomes.

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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 (..)

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STAT

OCTOBER 6, 2023

Califf proposed something radical: that private health care insurance companies (payers) should participate in clinical research on FDA-approved drugs. Bringing payers into clinical research could help solve these problems. Continue to STAT+ to read the full story…

FDA 106

FDA Insurance 106

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

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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.

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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

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 (..)

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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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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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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 131

Hospitals 131

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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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.

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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 (..)

Hospitals 98

Hospitals 98

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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STAT

AUGUST 21, 2023

But as digital health companies build out their weight loss businesses, capitalizing on the popularity of drugs like Wegovy and Ozempic, they’re courting a very different audience: payers and employers who have a vested interest in preventing quick scripts. The competition is growing quickly.

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Drug Topics

MAY 2, 2023

At the 2023 Asembia Specialty Pharmacy Summit, panelists discussed how inflation rebates and a redesign of Medicare Part D plans will impact payers and manufacturers.

Specialty Pharmacies 98

Specialty Pharmacies 98

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

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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.

Insurance 58

Insurance 58

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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Fierce Healthcare

APRIL 18, 2023

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

Hospitals 115

Hospitals 115

Fierce Healthcare

MARCH 28, 2024

Behavioral health company Forge Health looks to double down on payer, provider partnerships to serve complex medical patients hlandi Thu, 03/28/2024 - 09:01

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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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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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