payer-provider agreements

Latest Headlines

Latest Headlines

Payers must decide how much data to share with ACO providers

You know how when you go on a first date, you're careful not to divulge too much nitty-gritty information about yourself? Instead, most experienced daters prefer to reveal tidbits of their personal lives slowly, so as not to scare their dates off too early with tales of rough childhoods and embarrassing habits. They key to successful dates and early relationships often is a delicate give-and-take balance of sharing some information, but not too much. That's kind of how payers and providers are acting toward each other as they navigate the accountable care waters. Payers don't always want to spill all their beans, disclosing too much information too quickly, closely guarding their long-held secrets. And providers don't want to move forward with their dates if they remain tight-lipped about important information.

Highmark CEO: West Penn bankruptcy needed for merger approval

Highmark is defending itself against allegations that it forced West Penn Allegheny Health System into declaring bankruptcy. The two organizations are in court to determine whether Highmark can block...

Highmark moves in on UPMC with $65M hospital deal

Highmark is affiliating with Erie, Pa.-based Saint Vincent Health System, showing that the insurer's recent tangles with West Penn Allegheny Health System aren't thwarting its plans to build a dominant health delivery network to compete against UPMC.

Strong ACOs hinge on choosing the right provider partner

As accountable care organizations (ACO) continue to grow in popularity, payers are establishing new relationships with providers to help reduce healthcare costs and enhance quality care. But how can...

Amerigroup sells state operations after DOJ antitrust review

Amerigroup has agreed to sell its Virginia operations to health provider Inova after the U.S. Department of Justice's antitrust queries into WellPoint's $4.9 billion acquisition of the managed care insurer.

Highmark sues to block West Penn from other buyers

After West Penn Allegheny Health System canceled its deal to be purchased by Highmark last week, Highmark filed a lawsuit to prevent the health system from engaging in new acquisition discussions with other potential buyers.

Blues plans launch new ACOs in Tennessee, California

Two Blue Cross Blue Shield plans announced Wednesday they will launch new accountable care organizations (ACO) in Tennessee and California.