Financial Management

Latest Headlines

Latest Headlines

Google Capital invests $32.5M in Oscar

Google Capital has invested $32.5 million in Oscar, the startup health insurance company's CEO Mario Schlosser tells  the  Wall Street Journal. Now, Oscar is valued at $1.75 billion, up from $1.5 billion as of April.

Physician pay fairly flat in 2015, but trends continue to emerge

Overall, physicians' pay increased a mere 1.8 percent over the past year, according to the 2015 "Physician Compensation and Productivity Survey" from Minneapolis-based Sullivan, Cotter and Associates. 

Blue Cross Blue Shield of Michigan settles one suit, but faces more litigation

Blue Cross Blue Shield of Michigan settled a lawsuit with Aetna, but must now resolve another with Health Alliance Plan of Michigan. Both lawsuits deal with charging agreements with various Michigan hospitals. 

Appeals court resurrects precedent-setting suit against Aetna

The Third U.S. Circuit Court of Appeals has reversed a lower-court decision in a potentially precedent-setting case about the rules governing when healthcare providers can sue health insurers for payment of benefits.

The costly effects of charging seniors more for monthly premiums

Under the Affordable Care Act, individuals who are 64 and older cannot be charged more than three times as much as 21- to 24-year-olds for the same plan.  Many critics believe this 3-to-1 ratio discourages younger enrollees from purchasing plans and have thus proposed increasing the ratio to 5-to-1. But while 5-to-1 rate banding, as it's typically called, would insure more young people, federal health spending would increase and nearly 400,000 older people would lose coverage.

For many ACOs, patients cost Medicare more than projected

Patients at 45 percent of   accountable care organizations in 2014 cost Medicare more than the federal government had projected based on historic costs, according to a Kaiser Health News analysis of government records.

Sanders leads push for Medicare to negotiate drug prices

Democratic presidential candidate Bernie Sanders recently introduced legislation that would allow Medicare to negotiate prices with drug companies, which if enacted, could have major implications for both public and private payers.

After merger divestitures, MA market will be primed for disruption

In order to gain federal approval of their proposed mergers, some of the country's large insurers will have to sell off part of their Medicare Advantage business, leaving the market "ripe for disruption" by smaller plans.   

2 ways states' Medicaid ACOs can overcome challenges

As  Medicaid accountable care organizations continue to gain traction, their success largely will depend upon states' ability to generate savings and overcome challenges. For the most part, states adopt ACOs for two reasons: To reign in cost-related concerns and to coordinate care across populations. 

Study: Narrow pharmacy benefit networks improve medication adherence

Though there are growing concerns about narrow or preferred pharmacy networks, a CVS Health Research Institute study  published in  JAMA Internal Medicine  finds that such networks actually improve members' medication adherence.