Today’s payer-provider partnerships are more collaborative than ever. Historically transactional and defined by reimbursement and coverage-based decisions, the association has shifted dramatically as providers find themselves increasingly accountable for cost and quality.
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KLAS Research named Deloitte the top value-based care consultant in its 2019 "Best in KLAS" rankings.
Some firms are starting to collect data and sell "risk scores" to providers and payers that aim to identify which patients might misuse opioids, according to Politico.
Molina Healthcare abruptly notified 19,000 patients that they've been assigned to new physicians after a falling out with South Pasadena, Calif.-based Golden Shore Medical Group, according to The Sacramento Bee.
After an audit found Louisiana's Medicaid program misspent up to $85.5 million from 2016-18, two Republican lawmakers wrote a letter to CMS seeking information to determine if similar issues are occurring in other states, The Advocate reports.
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Anthem's shares hit a new record on Jan. 30 after the health insurer released strong financial results and said it will debut its pharmacy benefits management unit ahead of schedule, according to CNBC.
Lawmakers in New Mexico proposed legislation that would open its Medicaid program to paying customers, according to The Telegraph.
Cigna, which now owns pharmacy benefits manager Express Scripts, saw its net income fall in the fourth quarter of fiscal year 2018, according to recent financial documents.
Consumers shopping online for health insurance may encounter websites selling short-term health plans without clarifying that the plans are exempt from federal consumer protections, according to a market research scan completed by the Robert Wood Johnson Foundation and the Urban…
Sacramento, Calif.-based Sutter Health and Anthem Blue Cross of California are in a disagreement over rates, according to NPR.