Cigna To Sell Medicare Advantage In 67 More U.S. Counties
Cigna said it will expand its Medicare Advantage health plan offerings to seniors in 67 new counties and five new states next year in what has become the most competitive business for U. S. health insurers. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - October 1, 2020 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Business /business Retail /retail Decision Maker Content decisionmaker pharma Source Type: news

Insurers make pledge on mental health
Customers complain cover may be refused and decisions are poorly explained (Source: FT.com - Drugs and Healthcare)
Source: FT.com - Drugs and Healthcare - September 29, 2020 Category: Pharmaceuticals Source Type: news

Startup Doc.ai Inks Deal With Health Insurer Anthem, Names Female Cofounder CEO
The deal is worth $100 million over five years, according to CEO Sam De Brouwer, who is focused on scaling up doc.ai ’s enterprise offerings. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - September 29, 2020 Category: Pharmaceuticals Authors: Katie Jennings, Forbes Staff Tags: Healthcare /healthcare Innovation /innovation Enterprise Tech /enterprise-tech Cybersecurity /cybersecurity Editors' Pick editors-pick Coronavirus Source Type: news

Molina To Buy Affinity Health Plan For $380 Million In Medicaid Deal
Molina Healthcare said it will buy Affinity Health Plan for $380 million in cash, expanding the health insurer ’s Medicaid government health benefits businesses deeper into New York. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - September 29, 2020 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Business /business Retail /retail Editors' Pick editors-pick pharma Source Type: news

Independence Health Group releases 2019 financial results, reports 17% revenue growth
Independence Health Group Inc., the parent company of Independence Blue Cross, released 2019 financial results Friday that showed a 17% revenue growth for the region's largest health insurer. According to the report, Independence posted revenue of $19.2 billion and net income of $321 million — or 1.7% of total premium revenue. In 2018, the Center City-based company recorded revenue of $16.3 million and a net income of $324 million. “The health care system faced its greatest chal lenge in living… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 25, 2020 Category: Pharmaceuticals Authors: John George Source Type: news

Why Hospitals And Health Plans Worry About Trump ’s Supreme Court Pick
The possibility that Donald Trump will pick a conservative to replace U.S. Supreme Court Justice Ruth Bader Ginsburg has hospitals, health insurers and other medical care providers worried about the loss of millions of paying customers. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - September 25, 2020 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Money /money business pharma Source Type: news

Blue Cross Insurers Reach Tentative Settlement in Antitrust Lawsuit
The health insurance group may pay $2.7 billion to resolve allegations that the chain blocked competition. (Source: NYT Health)
Source: NYT Health - September 24, 2020 Category: Consumer Health News Authors: Reed Abelson Tags: your-feed-science Health Insurance and Managed Care Suits and Litigation (Civil) Aetna Inc Blue Cross and Blue Shield Assn CIGNA Corporation your-feed-healthcare Source Type: news

Growth in innovative, value-based contracts holds promise for the health system and for patients
The extraordinary financial pressure COVID-19 is creating for the U.S. economy underscores the need for a renewed push toward a more value-driven health care system that prioritizes patient access and affordability. Now more than ever, we need to make sure we ’re spending our health resources wisely. That’s why it’s heartening to see the number of innovative contracts grow between biopharmaceutical companies and insurance companies as potential solutions for better affordability and better outcomes. (Source: The Catalyst)
Source: The Catalyst - September 24, 2020 Category: Pharmaceuticals Authors: Katie Koziara Tags: Access Value-Driven Health Care The Value Collaborative Source Type: news

U.S. Hospitals Charging Insurers More Than Twice Medicare Rates U.S. Hospitals Charging Insurers More Than Twice Medicare Rates
Hospitals in the United States are charging private insurers 2.5 times what they get paid under the government Medicare program for the same services, according to a study released September 21.Georgia Health News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - September 24, 2020 Category: Consumer Health News Tags: Hospital Medicine News Source Type: news

Blue Cross Blue Shield of Kansas makes several executive-level appointments
Blue Cross and Blue Shield of Kansas, the state's largest health insurer, has promoted two vice presidents as part of its ongoing executive reorganization. The company said Treena Mason has been promoted to senior vice president of sales and operations. She will oversee employer group sales, over and under 65 individual sales, product development and the new VP of operations and CMS programs. She also serves as president of Advance Insurance Co. of K ansas. Mason, formerly the VP of group sales and… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 22, 2020 Category: Pharmaceuticals Authors: WBJ Staff Source Type: news

Study: Private insurers pay 2 1/2 times what Medicare does for hospital services
Private insurers paid roughly 2.5 times what Medicare paid for hospital-based treatment in 2018, an analysis released Friday by the RAND Corp. found. (Source: Health News - UPI.com)
Source: Health News - UPI.com - September 18, 2020 Category: Consumer Health News Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Transcatheter Valve Therapy (TVT) Registry; 2) Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007; 3) Part D Coordination of Benefits Data; and 4) State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline. Comments are due by November 17, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - September 18, 2020 Category: Rural Health Source Type: news

Many Hospitals Charge More Than Twice What Medicare Pays for the Same Care
The gap between rates set for private insurers and employers vs. those by the federal government stirs the debate over a government-run health plan. (Source: NYT Health)
Source: NYT Health - September 18, 2020 Category: Consumer Health News Authors: Reed Abelson Tags: Health Insurance and Managed Care Hospitals Medicare Patient Protection and Affordable Care Act (2010) Finances Prices (Fares, Fees and Rates) United States Politics and Government Research Regulation and Deregulation of Industry Rand Co Source Type: news

Damage from riots across the US may cost insurance companies more than $1 billion
(Natural News) The damage from riots sparked by the police killing of George Floyd may end up being the most expensive in U.S. history, costing insurance companies between $1 billion and $2 billion. The data comes from the Insurance Information Institute (Triple-I), which compiles information from a company called Property Claim Services (PCS). The latter... (Source: NaturalNews.com)
Source: NaturalNews.com - September 18, 2020 Category: Consumer Health News Source Type: news

Life insurers could help solve America’s healthcare shortfall
The pandemic-driven recession has deprived people of medical care when they most need it the most (Source: FT.com - Drugs and Healthcare)
Source: FT.com - Drugs and Healthcare - September 17, 2020 Category: Pharmaceuticals Source Type: news

Obamacare Choices Widen Even As Trump Tries To Kill Them
A parade of health insurance companies are offering individual coverage under the Affordable Care Act to hundreds of new counties for 2021 even as the Donald Trump White House pursues legal action to kill the law. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - September 13, 2020 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Money /money Election 2020 /election-2020 Editors' Pick editors-pick Decision Maker Content decisionmaker business pharma Source Type: news

Obamacare Choices Grow Even As Trump Tries To Kill Them
A parade of health insurance companies are offering individual coverage under the Affordable Care Act to hundreds of new counties for 2021 even as the Donald Trump White House pursues legal action to kill the law. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - September 13, 2020 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Money /money Election 2020 /election-2020 Editors' Pick editors-pick Decision Maker Content decisionmaker business pharma Source Type: news

Century 21 Stores files for bankruptcy, blames insurers
Century 21 Stores filed for Chapter 11 bankruptcy and will wind down operations at its 13 stores (Source: Reuters: Health)
Source: Reuters: Health - September 11, 2020 Category: Consumer Health News Source Type: news

Hypertension-Focused Medication Therapy Management: A Collaborative Pilot Program Uniting Pharmacists, Public Health, and Health Insurers in Wisconsin
(Source: CDC Preventing Chronic Disease)
Source: CDC Preventing Chronic Disease - September 10, 2020 Category: International Medicine & Public Health Tags: Public Health Source Type: news

Rising Costs May Curb Widespread Use of PrEP in US Rising Costs May Curb Widespread Use of PrEP in US
Widespread use of HIV preexposure prophylaxis (PrEP) in the US may be curtailed by escalating out-of-pocket costs as well as total costs, which include the portion covered by government and private insurers, a new study suggests.Reuters Health Information (Source: Medscape Hiv-Aids Headlines)
Source: Medscape Hiv-Aids Headlines - September 9, 2020 Category: Infectious Diseases Tags: HIV/AIDS News Source Type: news

Obamacare Co-Ops Down From 23 to Final'3 Little Miracles'Obamacare Co-Ops Down From 23 to Final'3 Little Miracles '
Lauded as a way to boost competition among insurers and hold down prices on the Obamacare exchanges, the co-ops had more than 1 million people enrolled in 26 states in 2015. Today, they cover about 128,000.Kaiser Health News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - September 9, 2020 Category: Consumer Health News Tags: Family Medicine/Primary Care News Source Type: news

Magellan Health appoints new CFO
The new chief financial officer joins the Scottsdale health insurance company from Cigna Corp. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 9, 2020 Category: Biotechnology Authors: Greg Barr Source Type: news

Innovative contracts drive access for patients and value for the system
Our health care system is far from perfect, but there are solutions that will help address patient affordability concerns without sacrificing innovation, access or quality of care. For example, biopharmaceutical companies are working with other health care stakeholders to develop new ways to pay for medicines through innovative, results-based contracts that can improve affordability and more tightly link the price of medicines to the outcomes they deliver for patients. Solutions like innovative contracts support continued access and innovation in health care in the United States by building on the current system and streng...
Source: The Catalyst - September 9, 2020 Category: Pharmaceuticals Authors: Katie Koziara Tags: Access The Value Collaborative Source Type: news

Insurer, Insured Costs for HIV PrEP Rising in the United States
WEDNESDAY, Sept. 9, 2020 -- From 2014 to 2018, there were increases noted in third-party and out-of-pocket (OOP) payments per 30 tenofovir disoproxil fumarate with emtricitabine (TDF-FTC) tablets for HIV preexposure prophylaxis (PrEP), according to... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - September 9, 2020 Category: Pharmaceuticals Source Type: news

Who pays for Covid testing in New York?
Health insurers say they shouldn't be paying the tab for surveillance testing, nor back-to-school/back-to-work tests. If they did, total costs in the second half of 2020 could hit $2.9 billion. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 4, 2020 Category: Biotechnology Authors: Tracey Drury Source Type: news

Who pays for Covid testing in New York?
Health insurers say they shouldn't be paying the tab for surveillance testing, nor back-to-school/back-to-work tests. If they did, total costs in the second half of 2020 could hit $2.9 billion. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 4, 2020 Category: Pharmaceuticals Authors: Tracey Drury Source Type: news

Medical Mutual partners with Ohio hospitals to broaden MedFlex HMO, compete with Cleveland Clinic
The move comes two weeks after Cleveland Clinic partnered with nationwide health insurer Aetna to launch a co-branded insurance plan, which aims at reducing health care costs for participating employers and other benefits. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 4, 2020 Category: Pharmaceuticals Authors: Mary Vanac Source Type: news

Medical Mutual partners with Ohio hospitals to broaden MedFlex HMO, compete with Cleveland Clinic
The move comes two weeks after Cleveland Clinic partnered with nationwide health insurer Aetna to launch a co-branded insurance plan, which aims at reducing health care costs for participating employers and other benefits. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 4, 2020 Category: Biotechnology Authors: Mary Vanac Source Type: news

Ringside, Revolution Hall sue insurer for Covid denials
The case could provide early insights into how courts will treat a wave of expected insurance disputes related to the pandemic. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 3, 2020 Category: Pharmaceuticals Authors: Andy Giegerich Source Type: news

Ringside, Revolution Hall sue insurer for Covid denials
The case could provide early insights into how courts will treat a wave of expected insurance disputes related to the pandemic. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 3, 2020 Category: Biotechnology Authors: Andy Giegerich Source Type: news

Long-term mortality and outcome in hospital survivors of septic shock, sepsis, and severe infections: The importance of aftercare
Patients with severe infections and especially sepsis have a high in-hospital mortality, but even hospital survivors face long-term sequelae, decreased health-related quality of life, and high risk of death, suggesting a great need for specialized aftercare. However, data regarding a potential benefit of post-discharge rehabilitation in these patients are scarce. In this retrospective matched cohort study the claim data of a large German statutory health care insurer was analyzed. 83,974 hospital survivors having suffered from septic shock, sepsis, and severe infections within the years 2009-2016 were identified using an I...
Source: Current Awareness Service for Health (CASH) - September 3, 2020 Category: Consumer Health News Source Type: news

Nine US States Cap Insulin Cost, but Activists Will'Fight Harder'Nine US States Cap Insulin Cost, but Activists Will'Fight Harder '
Drug makers and health insurers have not legally challenged state laws capping out-of-pocket insulin costs; still, such attempts to make insulin more affordable only apply to (Source: Medscape Diabetes Headlines)
Source: Medscape Diabetes Headlines - September 3, 2020 Category: Endocrinology Tags: Diabetes & Endocrinology News Source Type: news

More US States Cap Insulin Cost, but Activists Will'Fight Harder'More US States Cap Insulin Cost, but Activists Will'Fight Harder '
Drug makers and health insurers have not legally challenged state laws capping out-of-pocket insulin costs; still, such attempts to make insulin more affordable only apply to (Source: Medscape FamilyMedicine Headlines)
Source: Medscape FamilyMedicine Headlines - September 3, 2020 Category: Primary Care Tags: Diabetes & Endocrinology News Source Type: news

Navigating Safely Through The Pandemic
By Stephen LeahySep 2 2020 (IPS-Partners) Having reported on SARS, Ebola, Bird Flu (H5N1) outbreaks, as well as writing about efforts to combat HIV, I was horrified by what was going on in Wuhan, China last Jan mainly because of how fast this new SARS-CoV-2 virus spread. By early Feb it seemed likely there’d be a global pandemic and by the end of Feb I started to freak out as the pandemic took hold. I’ve never been to Wuhan or China nor seen anyone who had; and I hadn’t travelled any where recently. It was nearly impossible for me to have encountered the virus but that didn’t keep me from getting si...
Source: IPS Inter Press Service - Health - September 2, 2020 Category: International Medicine & Public Health Authors: Stephen Leahy Tags: Health Humanitarian Emergencies Source Type: news

Molina takes over Passport – but a $100 million question looms
The closure moves the Long Beach, California-based insurer closer to doing business in Kentucky. But it doesn't clarify what's going to happen to the once-vaunted West End headquarters project that Passport started and then stopped. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 1, 2020 Category: Biotechnology Authors: Chris Larson Source Type: news

For $5 and in 15 Minutes You Can Learn If You Have COVID-19
On Aug. 26, the U.S. Food and Drug Administration (FDA) gave an emergency use authorization (EUA) for a rapid COVID-19 test that can produce results in just 15 minutes, which could not only increase the number of people tested in the U.S., but also identify those who are positive sooner, so they can self-isolate and limit spread of the disease. The testing device, made by Abbott Laboratories and called BinaxNOW Ag Card, is about the size of a credit card and can be easily used anywhere people need to be tested. It analyzes samples from a nasal swab and comes with an app that people can download to receive their results&mda...
Source: TIME: Health - August 27, 2020 Category: Consumer Health News Authors: Alice Park Tags: Uncategorized COVID-19 Source Type: news

Online Therapy, Booming During the Coronavirus Pandemic, May Be Here to Stay
Mental health flows from the ceramic jug psychotherapist Lori Gottlieb keeps on her desk. There’s nothing special about the jug—a minor accessory in an office designed with the sort of tidy impersonality common to her field. And there’s no special elixir in it—just water. But all the same, the jug provides a certain kind of healing. When patients are struggling, crying, overcome in some way, Gottlieb, a Los Angeles based practitioner and author of the book Maybe You Should Talk to someone, will offer up a cup of water, pour it for them and hand it across. In that small gesture is a whole constellati...
Source: TIME: Health - August 27, 2020 Category: Consumer Health News Authors: Jeffrey Kluger Tags: Uncategorized COVID-19 Source Type: news

Blue Cross NC scales back cost cuts for Obamacare as pandemic impacts business
North Carolina's largest insurer will once again have an overall rate reduction for Affordable Care Act plans across the state. However, the cut will be considerably smaller than in past years as the company continues to navigate the financial impacts of the pandemic. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - August 27, 2020 Category: Pharmaceuticals Authors: Seth Thomas Gulledge Source Type: news

Bowser orders health insurers to cover high-risk residents ’ Covid-19 tests
Health insurers licensed in the District of Columbia will have to cover more coronavirus testing under an order from D.C. Mayor Muriel Bowser signed Wednesday.   Bowser ordered the insurers to cover testing up to once a week for people who work in high-risk environments, have been exposed to a person diagnosed with Covid-19, or have health issues that make them high-risk, according to her announcement.  The tests will be covered even if the insured per son is asymptomatic — such as an asymptomatic… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - August 26, 2020 Category: Biotechnology Authors: Rebecca Cooper Source Type: news

Verily launches new health insurance venture
Dubbed Coefficient Insurance Company, it will combine Verily and Swiss Re Corporate Solutions'technology.   (Source: mobihealthnews)
Source: mobihealthnews - August 25, 2020 Category: Information Technology Source Type: news

Paying for cell and gene therapy - Is the future already here?
The ascent of cell and gene therapies over the past few years has been astonishing. And their rise looks unstoppable: By 2025, the FDA expects it will be reviewing 10 to 20 of these transformative drugs per year.    But as we listen to affordability concerns from payers, providers and patients, we ’ve also had to ask, perhaps a bit provocatively, how we can afford to pay for this boom in future cures?  " Without solutions to help payers manage the cost, some of our members may make the choice to exclude coverage " , stated insurer CVS Health earlier in the year in its position paper on ...
Source: EyeForPharma - August 25, 2020 Category: Pharmaceuticals Authors: Ulrich Neumann Source Type: news

Paying for cell and gene therapy - Is the future already here?
The ascent of cell and gene therapies over the past few years has been astonishing. And their rise looks unstoppable: By 2025, the FDA expects it will be reviewing 10 to 20 of these transformative drugs per year.    But as we listen to affordability concerns from payers, providers and patients, we ’ve also had to ask, perhaps a bit provocatively, how we can afford to pay for this boom in future cures?  " Without solutions to help payers manage the cost, some of our members may make the choice to exclude coverage " , stated insurer CVS Health earlier in the year in its position paper on ...
Source: EyeForPharma - August 25, 2020 Category: Pharmaceuticals Authors: Ulrich Neumann Source Type: news

Ohio health insurer to invest $50M in affordable housing
"Housing undergirds other social determinants. Even now with Covid-19, people are safest when they stay home. But if they don't have a stable home, they aren't safe, let alone able to thrive. The pandemic has just brought out more how much support for housing is needed." (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - August 23, 2020 Category: Pharmaceuticals Authors: Tristan Navera Source Type: news

Ohio health insurer to invest $50M in affordable housing
"Housing undergirds other social determinants. Even now with Covid-19, people are safest when they stay home. But if they don't have a stable home, they aren't safe, let alone able to thrive. The pandemic has just brought out more how much support for housing is needed." (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - August 23, 2020 Category: Biotechnology Authors: Tristan Navera Source Type: news

Emids buys Nevada IT consulting firm, FlexTech
The deal was driven by the need for insurers to adopt more digital-based options and will enable Emids ’ clients to accelerate that process. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - August 20, 2020 Category: Pharmaceuticals Authors: Joel Stinnett Source Type: news

Oregon insurers receive boost from Covid-19 in first-half results
Gov. Kate Brown put a halt to elective procedures for several weeks, so claims fell. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - August 19, 2020 Category: Pharmaceuticals Authors: Elizabeth Hayes Source Type: news

Oregon insurers receive boost from Covid-19 in first-half results
Gov. Kate Brown put a halt to elective procedures for several weeks, so claims fell. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - August 19, 2020 Category: Biotechnology Authors: Elizabeth Hayes Source Type: news

Blue Cross NC says value-based care saved $153 million in year one
The state's largest insurer says that its push to reform health-care's payment system has already saved more than $153 million in its first year of operation, as it continues working to enroll more of its providers into the cost-sharing arrangements. Blue Cross and Blue Shield of North Carolina first launched its value-based care plan, Blue Premier, in January 2019 alongside five of the state's largest hospital systems. The plan replaced the traditional "fee-for-service" model, reimbursing providers… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - August 17, 2020 Category: Pharmaceuticals Authors: Seth Thomas Gulledge Source Type: news

NJ radiology firm sues Cigna for reimbursement denial
A New Jersey radiology firm is suing healthcare insurer Cigna Health, claiming...Read more on AuntMinnie.comRelated Reading: Cigna posts high-tech imaging hospital coverage policy Old CT image shows screw in 5-year-old's jaw, ends in surgery ProScan accused of submitting fraudulent MRI claims Groups urge mandated coverage for CT colonography Cigna revises policy, will now pay for screening DBT (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - August 14, 2020 Category: Radiology Source Type: news