Katherine Moody

Articles by Katherine Moody

At AHIP policy conference, leaders talk new payment models, drug prices

During America's Health Insurance Plans' National Health Policy Conference, AHIP President and CEO Marilyn Tavenner said the private sector is taking the lead in the effort to provide better value in the healthcare system. 

4 ways health insurers can move to a consumer-centric business model

Healthcare under the Affordable Care Act is becoming more customer-centric, and if insurance companies want to succeed, they must move from a purely transactional relationship with their members toward a customer-first relationship, according to an article from Advertising Age.

 

BCBS of North Carolina could face hefty fines for administrative issues

Blue Cross Blue Shield of North Carolina, which continues to grapple with technology issues that have wrecked havoc on its enrollment and billing systems, may be facing $1,000 or more in fines a day per violation, according to an article from the News & Observer.

 

Insurer-paramedicine partnership looks to reduce ER admissions

As a part of an initiative to curb unnecessary hospitalizations and healthcare costs, Blue Cross Blue Shield New Mexico has partnered with Albuquerque Ambulance and American Medical Response to care for high-risk Medicaid patients in their homes, according to the Albuquerque Journal.

 

NJ payer and provider find common ground in population health goals

Although commercial payers and behavioral health providers are often at odds, two New Jersey companies are working together on a bundled payment model to help improve population health.

Critics push back against new Medicare Part B payment proposals

When the Obama administration announced its plan to test new ways of paying for prescription drugs under Medicare Part B, a slew of criticism from industry stakeholders quickly followed--though some say they see potential in the new models.

 

Aetna merges iTriage with WellMatch

Aetna has merged its health app-maker subsidiary, iTriage, with its cost transparency business, WellMatch, to form one group, according to MobiHealthNews.

Many Americans owe IRS for health insurance subsidy overpayments

Many people who received subsidies to help pay for their Affordable Care Act policies in the form of tax credits will find that they owe some of that money to the government during tax season, and others are facing stiffer penalties for remaining uninsured. 

Cigna exec: Quality metrics do more good than harm

Quality metrics are usually met with groans from physicians, but a Cigna executive tells Medical Economics that they play a vital role for commercial insurance companies that are trying to help doctors improve the care they provide patients.

 

CMS changes will cut Medicare Advantage payments, report says

Recently proposed changes to Medicare Advantage payment rules will result in an estimated 0.5 to 3.9 percent cut on average to MA payments in 2017, according to a new report.