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Half of Americans support Sanders' single-payer plan, but control, cost concerns remain


Americans are divided about the idea of creating a single-payer government health insurance system, as Democratic presidential candidate Bernie Sanders has proposed, but support shrinks when negative arguments are highlighted and alternatives are presented, according to a poll released Thursday. Read more »

CMS: 1.35% increase in payment for Medicare Advantage plans; insurers average 3.5% gain


The Centers for Medicare and Medicaid Services on Friday released proposed changes for the Medicare Advantage and Part D prescription drug programs for 2017, including an increase in the net payment rate for Medicare Advantage of 1.35 percent, CMS said. Read more »

Missouri hospitals bear costs of high uninsured rate; uncompensated care swells 469%


Uncompensated care in Missouri's hospitals swelled 469 percent over a 10-year period, from 2004 to 2014 -- rising from $154 million to $723 million over that span, according to the Missouri Hospital Association's annual Community Investment Report, which examines community benefit and economic data. Read more »

Health and Human Services approves Arkansas's plan to preserve Medicaid expansion


Arkansas Gov. Asa Hutchinson said Wednesday that federal officials have approved most of his requested changes to the state's Medicaid expansion program and urged the legislature to continue it. Read more »

America's Health Insurance Plans urges CMS to keep current Medicare Advantage payment plan


On Friday, the Centers for Medicare and Medicaid Services was expected to release its preliminary payment plan for Medicare Advantage in policies to address growth rates, risk adjustment and the star ratings system. Read more »

Regulators approve, with conditions, Aetna's acquisition of Humana in Florida


Florida insurance regulators have approved Aetna's acquisition of Humana's affiliates there, but with conditions, according to a consent order issued last week. Read more »

Access to in-network pharmacies crucial to lower coinsurance rates, CMS says


Medicare beneficiaries who live in urban areas may save money on their prescription drugs this year because they have better access to pharmacies in drug plan networks that charge lower copayments or coinsurance, according to the federal Centers for Medicare & Medicaid Services. Read more »

CMS, America's Health Insurance Plans release standard quality measures among payers


For the first time, the Centers for Medicare and Medicaid Services and America's Health Insurance Plans have announced standard quality measures among payers, a move designed to reduce confusion and complexity for reporting providers. Read more »

Kaiser Foundation Health Plan, hospitals report decline in net income, increase in membership


Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries reported a $1.2 billion decrease in profit year over year, according to their 2015 annual and fourth quarter financial results. Read more »

Insurers covering high cost exchange members to get $7.7 billion in reinsurance payments


Health insurers who sold plans through the marketplaces in 2015, and who covered high cost individuals can expect to get $7.7 billion this year through the federal reinsurance program established under the Affordable Care Act, the Centers for Medicare and Medicaid Services announced Feb. 12. Read more »

McKesson and Health QX build alliance to help insurers use bundled payment models


McKesson Health Solutions and Health QX on Wednesday announced an alliance designed to help insurers quickly design and scale complex bundled payment models. Read more »

California wields power to decide which insurers can join the exchange, and at what price


Experts say the California exchange uses more of its powers as an "active purchaser" than any other state. That means it can decide which insurers can join the exchange, what plans and benefits are available and at what price. Read more »

President's budget, dead on arrival, gives states incentives to expand Medicaid


Though President Barack Obama's proposed 2017 budget died almost as fast as it arrived at Congress on Tuesday, the chief executive's final proposal included millions in healthcare spending to bolster quality programs, improve interoperability and fight rising pharmaceutical prices. Read more »

HCA, Verizon, among 20 major companies forming healthcare alliance to get data, control costs


Twenty major companies, including American Express, Verizon, Coca-Cola and HCA have joined the newly-launched Health Transformation Alliance to combine data on the population health of their employees, and potentially flex their muscle with insurance companies and big pharma, according to Tevi Troy, president of the American Health Policy Institute. Read more »

Covered California says UnitedHealth should own up to $475M loss and stop blaming Obamacare


Peter Lee said UnitedHealth made a series of blunders on rates and networks that led to a $475 million loss last year. Read more »

Open enrollment nets 12.7 million for Obamacare, exceeding expectations, HHS says


The last-minute surge lifted the total enrollment in Obamacare to 12.7 million this year, accounting for 9.6 million consumers enrolled or re-enrolled for coverage through Healthcare.gov and the 3.1 million people who selected plans through the state-based marketplaces. Read more »

Anthem, Aetna, Cigna among insurers trying to limit special enrollment signups, report says


Stung by losses under the federal health law, major insurers are seeking to sharply limit how policies are sold to individuals in ways that consumer advocates say seem to illegally discriminate against the sickest and could hold down future enrollment. Read more »

Blue Cross coverage of genetic testing for some cancers raises debate over expensive screenings


Pennsylvania-based Independence Blue Cross' announcement that it will cover a complex type of genetic testing for some cancer patients thrusts the insurer into an ongoing debate about how to handle an increasing array of these expensive tests. Read more »

Despite rate hikes, Obamacare sign-ups strong in North Carolina


North Carolina's average premium increases on the Obamacare exchange are among the highest in the country, according to federal data. The Obama administration warned this open enrollment period, which closes Jan. 31, could be particularly tough because many of the sickest, and therefore most motivated, people already bought plans. Read more »

CMS proposes sharing and selling analyses of claims data to improve care


The Centers for Medicare and Medicaid Services has proposed new rules it expects will expand access to analysis and data that helps employers and providers make more informed decisions about care delivery. Read more »

The pros and cons of short-term health plans


For some people -- especially those who are young, healthy and don't qualify for a tax credit from Covered California or other health insurance exchange -- short-term plans might make financial sense, even though they don't shield you from the Obamacare tax penalty. Read more »

Centene says hard drive loss due to employee error; Merger with Health Net expected early 2016


Health insurer Centene this week said the loss of six hard drives with health information in 950,000 beneficiaries was a result of an employee error. Read more »

Providers and insurers benefit from Medicaid expansion, former CMS director Cindy Mann says


Hospitals and payers benefit from Medicaid expansion, according to an attorney who formerly directed the Medicaid program for the Centers for Medicare and Medicaid Services. Read more »

Close to 9 million enroll in Obamacare as January 31 deadline nears, HHS says


With the final January 31 deadline for open enrollment looming, close to 9 million consumers have signed up for healthcare coverage through the marketplace, according to the Centers for Medicare and Medicaid Services. Read more »

CMS releases aligned payer and provider incentives for dual-eligibles


A longstanding barrier to improving quality and reducing costs of care for Medicare-Medicaid enrollees has been a lack of alignment and cohesiveness between the two programs, including misaligned incentives for payers and providers, according to the Centers for Medicare and Medicaid Services.

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