Healthcare Reform Blog

Fresh U.S. healthcare insights from expert analysts on Healthcare Reform, ACOs, Exchanges, Medicaid, Medicare, regional and national trends…and much more

Sarah WilsonContributor: Sarah Wilson
Topic: “Health plan acquisitions”, Aetna, Cigna, Humana, “Medicare Advantage”

Aetna made an aggressive move with its acquisition of Coventry in 2013, and now rumors are swirling that Aetna will soon announce a new acquisition. But this time, the acquisition target may be more than a boutique company like Coventry that would enhance one of Aetna’s existing service lines.

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Posted on: 5/19/2015 1:16:41 PM


AnnJeanette ColwellContributor: AnnJeanette Colwell
Topic: SCOTUS, FTC, “health systems acquisitions”

The U.S. Supreme Court has spoken. Or, in this case, it has made its opinion known by its silence. The court recently declined to hear an appeal of a case that has brought national attention to the Toledo, Ohio, market by forcing the dissolution of a major health system merger.

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Posted on: 5/14/2015 4:48:45 PM


Chris SilvaContributor: Chris Silva
Topics: Teladoc “Texas Medical Board” telemedicine

Ongoing litigation between telemedicine pioneer Teladoc and Texas physicians could have a significant impact on the definition of remote consultations and the powers of medical boards nationwide. Read more.
Posted on: 5/14/2015 3:32:40 PM


Contributor: Jane DuBose
Topic: Alternative payment model, medical homes, primary-care physicians

Medical homes have become such a common part of any discussion of healthcare coordination that one might think they’re everywhere. Read more.
Posted on: 5/11/2015 9:11:33 AM


Bill Melville

Contributor: Bill Melville
Topic: Medicare, “Children’s Health Insurance Program”, “Merit-Based Payment Incentive System”

Stop me if you’ve heard this before: “Congress is working to fix the Medicare funding formula physicians.” That has been a common refrain in the nation’s capital, only this time it appears to be more than lip service.

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Posted on: 4/23/2015 2:10:50 PM


Sheri SellmeyerContributer: Sheri Sellmeyer
Topic: UnitedHealthcare, exchanges

UnitedHealthcare looked as if it had missed the boat last year when it chose to play in just a handful of states in the healthcare exchanges. But what a difference a year and some competitive pricing makes: Its exchange enrollment has grown by more than 2,700 percent -- to 570,000 -- now that it has a presence in almost half of the states’ health insurance marketplaces for individuals. Read more.
Posted on: 4/22/2015 5:05:06 PM


Jenny Kerr

Contributor: Jenny Kerr
Topic: “California Public Employees’” Retirement System, Anthem, “Blue Shield of California”, “Affordable Care Act”

The impending Cadillac tax in 2018 seemed like a tax on health plans with ultra-rich benefits when it was passed, but the reality is it could hit about one-third of employers if left unchanged.

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Posted on: 4/22/2015 12:09:18 PM


Jane DuboseContributor: Jane Dubose
Topic: SGR, FFS, value-based reimbursement, CHIP, quality

On April 14, 1865, John Wilkes Booth walked into the Ford Theater, entered the presidential box and shot President Abraham Lincoln in the head, forever changing U.S. history.
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Posted on: 4/15/2015 1:58:22 PM


Lyda PhillipsContributor: Lyda Phillips
Topics:  Catamaran, CVS Health, Express Scripts, M&A, OptumRx, PBMs, UnitedHealth Group

Since late 2014, insiders have been predicting greater consolidation in the pharmacy benefit management industry. Rite Aid’s acquisition of EnvisionRx earlier this year supported that expectation, and the healthcare wise men and women nodded.
Read more.
Posted on: 4/1/2015 11:53:19 AM


Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: ACA, Aetna, Anthem, BCBS of North Carolina, Centene, exchanges, PreferredOne, UnitedHealth Group

Now that the dust has settled on year two of open enrollment for the health insurance exchanges, it’s a good time to bust a few myths about the program. Read more.
Posted on: 3/26/2015 4:54:57 PM


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