Medicare & Medicaid

Aetna whistleblower accuses CVS Health of fraud
Apr 10 | Susan Morse
In commercial contracts Caremark kept the spread between the price it negotiated with the pharmacies…
AHIP: Medicaid advances use of preventative care services
Apr 09 | Susan Morse
Adults are four times as likely, and children at least two-times more likely, to…
Star ratings jump strengthens MA plans
Apr 04 | Susan Morse
MA star ratings improvements can help plans expand their share of an increasingly saturated market.
Maryland experiment falls short of financial goals
Apr 04 | Jeff Lagasse
Paying hospitals a fixed global budget reduced their prices but individual physicians continued to…
Survey: Physicians like Medicaid work requirements
Apr 03 | Beth Jones Sanborn
"The survey strongly suggests that the majority of physicians would like to move away from the…
Physicians see $11-54B of challenged revenue
Apr 03 | Jeff Lagasse
While conventional wisdom holds that it should be more challenging for doctors to bill private…
BayCare, Lumeris partner on a Medicare Advantage plan
Apr 03 | Susan Morse
The integrated provider-payer network is expected to grow as Lumeris builds a network of physicians and hospitals…
Apr 03 | Jeff Lagasse
While the MSSP overall was a net cost to CMS in 2016, there is evidence that…
Apr 02 | Susan Morse
CMS is also increasing the percent of encounter data in risk scores, a…
Optum, UnitedHealthcare, Humana, others launch blockchain pilot
Apr 02 | Susan Morse
The alliance is one of the first, if not the first, national blockchain alliances…