Health Plan Weekly

Payers Bet on Telemedicine to Solve Primary Care Challenges

Access to primary care is one of the crucial challenges facing the health care system. As payers and providers try to rein in specialist and acute care overuse, preventive medicine and patient education — central ...
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Nebraska Applies for Two-Tiered Medicaid Expansion Waiver

With Medicaid demonstration programs that include work requirements struck down in three states, it’s become increasingly clear that such waivers may not survive legal scrutiny. So Nebraska, which last month submi...
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CVS Health Proposes Four Ways To Cope With Gene Therapy Cost

As payers brace themselves for accelerated approvals of cell and gene therapies, they are searching for ways to manage those costs. In an effort to keep pace with competitors, CVS Health Corp. entered the fray, sket...
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Supreme Court Declines Expedited Review of ACA Lawsuit

In a blow to the managed care industry, the Supreme Court chose to delay intervening in Texas v. United States, the Republican state attorneys general-led lawsuit that would overturn the Affordable Care Act (ACA). ...
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News Briefs

✦ Having now satisfied all necessary regulatory requirements, Centene Corp. and WellCare Health Plans, Inc. closed their $17 billion deal on Jan. 23. Centene is the country’s largest managed Medicaid insurer and...
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‘Hotspotting’ Study Stirs Debate About Social Determinants with Chart: Health Care ‘Hotspotting’ Program Shows Little Effect on Medically Complex Patients

In the health care industry, it’s become almost dogma that a small number of “superutilizers” — typically patients with complex medical and social challenges — are driving a disproportionate share of costs...
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Supreme Court Agrees to Decide if PBMs Fall Under ERISA

The Supreme Court has agreed to hear a case that observers say ultimately could upend state-based efforts to regulate PBMs and potentially even lead to legislation on the federal level to rein them in. The lawsuit, ...
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UnitedHealth Owes Strong 2019 Results to UHC, Optum Units

UnitedHealth Group beat analysts’ earnings-per-share estimate for 2019’s fourth quarter, driven by strong performance in both its UnitedHealthcare and Optum segments. For the full 2019 calendar year, earnings...
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Individual Insurance Market Had Profitable, Stable Performance in 2019

The individual insurance market’s financial performance remained stable in the first nine months of 2019, despite the repeal of the individual mandate tax penalty, according to a recent analysis by the Kaiser Fami...
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News Briefs

✦ The Trump administration and Republican state attorneys general filed a countermotion against a bid by Democratic state attorneys general and House Democrats to speed the Supreme Court’s review of the U.S. Cou...
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