UnitedHealth Group launched its concierge service, Navigate4Me just last year. The insurer already significantly expanded the services it offers to its Medicare Advantage enrollees.
The service started with just 12 navigators and has expanded...National News
The public squabble has lasted nearly a year, but now the two have agreed to extend their nationwide contract effective January 1, 2019.
UnitedHealthcare (UHC) has threatened for months to end its contract with Envision Healthcare. Envision fired the first shot this spring and missed its target when it was forced into arbitration...National News
Two unnamed Medicaid managed care organizations (MCOs) in Arizona showed significant access control and configuration vulnerabilities in a Nov. 23 security review by the Office of Inspector General (OIG). Officials identified 19 different security flaws, suggesting other state MCOs could also be susceptible to risk.
The OIG...National News
Last week, the Centers for Medicare and Medicaid Services (CMS) released four State Empowerment and Relief waiver concepts for states to utilize under the Affordable Care Act’s (ACA) section 1332. CMS aims to encourage innovation and reduce burdens with the waivers, an action commended by Health and Human Services (HHS) secretary Alex...National News
The ink is barely dry on its $69 billion merger with Aetna and now CVS drops the news on its new Guaranteed Net Cost pricing model designed to simplify the financial arrangements underlying PBM contracts. CVS said it can deliver savings through PBM cost management strategies such as formulary, utilization management and performance...National News
Insurance is evolving and Minneapolis-based Bright Health is a testament to the confidence shift toward technology-centered insurers. The healthcare startup just closed its largest funding round yet, totaling $200 million, a series C pool of capital that raised more money than expected.
Bright Health may be new in an industry...National News
Megan Callahan, former chief strategy officer for McKesson was hired as Lyft's health lead as the company grows its healthcare business that focuses on aiding patients to get to their medical appointments on time.
There is buzz the company may go public in 2019 and Lyft may be looking to hike up revenues in the interim. CNBC...National News
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to lower prescription drug costs for beneficiaries by making changes to Medicare Part D. The proposal could give insurers negotiating powers on drug prices by offering an expectation that plans would implement broader use of prior authorization (PA)...National News
One of the nation's pharmacy giants merges with one of the biggest health insurers with a vision of improving healthcare.
When announcing the deal on Wednesday, CVS Health President and CEO Larry Merlo said,
Today marks the start of a new day in health care and a transformative moment for our company and our industry. By delivering...National News
The new, revolutionary treatment is only available at 175 hospitals across the nation.
This week, The Wall Street Journal reported on the challenges stroke victims face when a comprehensive stroke center isn't in the neighborhood.
Quoting Ryan McTaggart, director of interventional neuroradiology at Rhode Island Hospital,
There is...National News
Democrats took the House during midterm elections, leaving a divided Congress to take on legislation. Healthcare policies and ideas were big ticket items on the campaign trail and Democrats are eager to implement their plans.
According to a CNN's exit polling, 41 percent of respondents said healthcare was the most important issue...National News
The California Attorney Generals office gave Dignity Health and Catholic Health Initiatives (CHI) conditional approval to merge and create a non-profit health system--CommonSpirit Health. Last November the two hospitals signed an agreement to combine operations following a year of negotiations.
CommonSpirit Health will include...National News
Athletic Incident Management System (AIMS) was developed by Mayo Clinic Arizona sports neurology and concussion program co-director Jennifer Wethe, PhD. The program collects data on brain injuries, educates parents and young athletes on concussions and can help keep children safe and improve recovery after injuries. US Soccer...National News
The Department of Homeland Security announced the proposal of a “public charge” in September that if enacted, would authorize the government to issue penalties to immigrants using federal programs such as Medicare or Medicaid funded through taxpayer-dollars.
A “public charge” assesses the likeliness of an immigrant being...National News
For the first time in eight years, the 2018 Medicare fee-for-service improper payment rate has seen a decline of over $4.5 billion and a drop in home health improper payments is a big contributor to the lower rate.
The rate was at 9.51 percent in 2017 and is now at 8.12 percent. This is the lowest the improper payment rate has...National News
This enrollment period marks the first where individuals will not incur penalties for failing to purchase health insurance coverage and compared to last year's numbers, Affordable Care Act (ACA) enrollment has declined by eight percent in its first two weeks.
With more insurers entering the individual marketplace and incumbents...National News
The proposed rule follows a final rule published earlier this month that says it "will provide conscience protections for Americans who have a religious or moral objection to health insurance that covers contraception methods."
The proposal allows women with employer-based insurance that excludes contraceptives to attain them under...
Virginia-based Kaleo, a private drug company, increased the price of an opioid overdose antidote by over 600 percent. EVZIO, the talking auto-injector uses naloxone to reverse the potentially fatal effects of an opioid overdose and talks the user through its instructions during use.
Prices for a complete naloxone kit alone starts at...
According to the American Medical Association the words patients and physicians use to describe the current prior authorization process: Time-consuming, tedious and horrendous.
During its annual meeting of delegates, The American Medical Association announced it wants government officials to carefully consider evidence that prior...National News
Caring for more than 1 million employees requires lots of dealmaking; the retail giant is launching insurance products tied to value-based contracts.
Walmart works with ACOs linked to Banner Health in Arizona and last month the retailer partnered with Ochsner Accountable Care to offer a plan to workers in the New Orleans Metro, Baton...