Latest Headlines

Latest Headlines

Highmark unveils bundled-payment model for cancer care

Following in the footsteps of other major insurers, Highmark will debut a bundled-payment initiative aimed at paying for value in cancer care, according to the  Pittsburgh Post-Gazette.

Highmark CEO: ACA marketplace stabilization requires a community approach

Highlighting the benefits of an integrated health system, Highmark CEO David Holmberg told  Trib Live  that a "healthcare community" approach to care will bring stability to the Affordable Care Act marketplace.  

Physicians push back against Highmark reimbursement cuts

The Pennsylvania physician community lashed out against a recent decision by one of the state's major insurance carriers to cut payments by 4.5 percent, claiming the cuts are placing an unfair burden on providers, which could negatively impact patient care in the long run.

Highmark will cut physician payments to stem ACA-compliant plan losses

As part of a broader effort to stem losses from Affordable Care Act plans, insurer Highmark, Inc. will cut physician reimbursement rates for those plans by 4.5 percent starting in April.

Highmark GPO boosts hospitals' bottom lines, outcomes

A little-known subsidiary of the insurer Highmark is playing a growing role in cutting costs for hospitals, according to the Pittsburgh Post-Gazette.

Highmark will shift to narrow-network plans amid losses in exchange business

Facing financial losses, Pittsburgh-based insurer Highmark will shift gears in terms of what it offers through the Affordable Care Act exchanges, opting for more narrow-network plans, according to the  Wall Street Journal.  

Blue Cross of Northeastern Pennsylvania faces lawsuit for charitable donation

A class-action lawsuit accuses the insurer formerly known as Blue Cross of Northeastern Pennsylvania of "blatantly unlawful conduct" by donating $90 million to charity rather than distributing that surplus to its members.

Highmark anti-fraud efforts saved $100 million in 2014

Anti-fraud efforts involving data analysis and coding investigations saved Highmark Inc. more than $100 million last year.

Court: UPMC to maintain Highmark's Medicare Advantage in-network rates

A ruling by Pennsylvania Commonwealth Court Judge Dan Pellegrini mandates that the University of Pittsburgh Medical Center maintain in-network rates until 2019 for Highmark's Medicare Advantage members.

Payers positioned to lead alternative payment model transformation

Earlier this year, the  Department of Health and Human Services announced it would fundamentally reform how it pays providers for treating Medicare patients.  FierceHealthPayer  spoke with three industry executives at two insurance companies to discuss payers' role to align with providers to meet this goal.