Insurers say advances in medical care are prompting them to review more cases before deciding on coverage. They say the checks are not meant to delay or stifle care, but doctors say they worry about the growing influence insurers have over patient treatment.
Indianapolis-based Anthem Inc. topped second quarter expectations and raised its 2019 forecast again. The health insurer also said Wednesday that the start of its new pharmacy benefit manager is going better than expected.
The Indianapolis-based insurer is telling members that those small, freestanding hospitals are out of its network and could be much costlier to use.
Even excluding the 78.8 million records stolen from health insurer Anthem, the number of patient records stolen from Indiana health care organizations spiraled to 4.3 million from about 69,000 in 2014.
Despite its low cost of living, Indianapolis is among the highest-priced areas for hospital services for patients with private health insurance—and is far more costly than Boston, Chicago, Manhattan and Los Angeles, according to a new study.
Anthem touts program saving $9.51 per patient per month—but passes on less than half the savings to hospitals and doctors.
UnitedHealthcare, MDwise, IU Health Plans and Assurant all disclosed losses during the first nine months of this year on the policies they are selling on the federal marketplace created by the Affordable Care Act.
Profits and patient visits remain strong at Community Health Network and Indiana University Health, but their Obamacare-fueled growth is decelerating.
The Indianapolis-based hospital system said its efforts to reduce patients’ need for expensive health care services, known as population health, slashed the use of hospitals, nursing homes and expensive imaging scans among the 140,000 Hoosiers IU Health now serves.
The Indianapolis-based law firm opened two new offices this fall—in Dallas and Seattle—and has now added five new offices in the past 24 months, as it tries to keep up with consolidation among hospitals and doctors.
Spending on prescription drugs has soared 451 percent this year at Indianapolis-based MDwise as new drugs for hepatitis C and cancer soar above $100,000 per patient.
Bryan Mills, CEO of the Community Health Network hospital system, said a recent pickup in health care construction could slow down if providers can successfully care for patients remotely via the Internet and phones.
A 22-page timeline of events leading up to the $54 billion merger agreement between Anthem and Cigna shows that company executives fell in love early, but the Anthem board made them break up and they chased other lovers. But in the end, they were each other’s only choice.
A flood of money from Obamacare—for the expanded Healthy Indiana Plan and for private health insurance purchased on the federal exchange—is boosting revenue and profit among Indiana health insurers.
CEO Bryan Mills has set a goal to make 75 percent of revenue—or $1.5 billion a year—be covered by value-based contracts—which means Community would be rewarded for keeping patients out of the hospital. A new venture is Mills’ strategy to get there.
A recent study found the number of health insurers offering broad provider networks on the Obamacare exchange was higher than in all but 10 other states and suggests that so long as Hoosiers keep singing “Don’t Fence Me In,” they could keep paying more for health insurance.
Profits at most county-owned hospitals have grown by 100 percent to 400 percent over the past four years via partnerships with nursing homes that have brought in hundreds of millions of dollars in extra federal money.
With this year’s bill estimated at $37 billion and counting, perhaps the sheer cost of cleaning up after IT security breaches at health care organizations will spur the industry to find a bandage for its hemorrhaging computer systems.
Anthem turned out unheard of gains in 2014, the first year of Obamacare’s new health insurance overhaul, as Anthem’s customers numbers held steady but their spending with hospitals and doctors plummeted.