Susan Morse

Baby boomers, higher income, will drive growth in healthcare spending over the next 8 years, CMS Office of the Actuary projects.

Aetna's individual Part D plan business, which was sold to WellCare, was the only area of concern for a lessening of competition, the DOJ said.

The pilot program for expanded services and medical equipment is being tested at three locations in Houston.

The 5-year model is testing for treatment in place of and for emergency transport to an alternative destination, such as a 24-hour care clinic.

AI will spur innovation in technology that comes from sources other than healthcare that will help the industry to adapt, expert says.

Healthcare providers and plans need to implement open data sharing technologies to support transitions of care as patients move between plan types.

Health plans doing business in Medicare, Medicaid, and the ACA are being asked to share claims data, and all information should be transferable, Verma says.

Pharma wants to be a part of value-based programs in risk-based arrangements with payers.

Value-based care demands the switch to wellcare to raise outcomes and decrease costs, Claire Pomeroy says.

There's a whole lot of finger pointing happening among feds, providers, payers, pharmacy benefits managers and big pharma, in what HHS Secretary Azar called the "dirty, little secret of drug pricing."