Payers

Commercial insurers, the employer and individual market, plus Medicare trends, Medicare Advantage, & Medicaid managed care

2019 Year in Preview
Susan Ladika
Insurers are busy merging with retailers and providers in vertical integration deals after attempts at horizontal combinations hit antitrust roadblocks.
2019 Year in Preview
Jan Greene
The labor market is tight (an un-employment rate of under 4%) and the Cadillac tax is still a can kicked down the road.
The Payers’ Playbook
Joseph Burns
Patient advocates say ‘fail first’ rules should be available online and decisions on physician appeals should be made within 72 hours–and in a day when it is an emergency.
Susan Ladika
Vertical integration may make sense in the era of value-based care. But will the combinations limit patient choice–and pass antitrust muster?
What Works
Michael D. Dalzell
The caveats: P4P programs don’t have a great track record, and avoiding risky patients may prove to be an unintended consequence.
What Works
Timothy Kelley
The caveats: Recent research says the evidence for improved outcomes was of moderate quality. And VBID still hasn’t proved its mettle as a cost saver.
Joseph Burns
The United States spends more—close to double—on health care per capita than other rich countries. By many measures, we’re not getting a good return on those trillions of dollars.
Seeds of Innovation
Peter Wehrwein
Our inaugural innovation issue!