Susan Morse
UnitedHealthcare and Oxford Health Insurance contended the payments to New York were an unconstitutional taking of their property.
Insurer is investing in at-home and hospice organizations and is focusing on senior primary care through Walgreens partnership.
Some drug companies pay less than what they would otherwise owe by introducing a new drug formulation, HHS Secretary Alex Azar says.
Automating core administrative functions equates to unlocking $15 million in operating income for every 100 full-time employees, Accenture says.
Providers conduct 77 million prior authorizations a year, and getting payers and providers to use one standard could also save $6.84 per transaction.
Administrator Seema Verma says it's time for ACOs to take on downside risk, in a proposal that would save Medicare $2.2 billion over 10 years.
The 2018 benefit year will now determine risk adjustment payments to insurers, using the statewide average premium.
'One nut that we haven't really cracked is how we effectively engage patients,' says bundled payment expert.
As a result of divestiture activity at Tenet and other customers, Conifer's revenue decreased 3.5 percent in Q2 2018 compared to last year.
Starting in 2019, insurers may use step therapy to choose the least expensive drug first before moving on to another prescription.