Payers, Providers Debate Health Plan Consolidation Before Congress

http://healthleadersmedia.com/content.cfm?topic=HEP&content_id=321160

Capitol Dome

In the second hearing this month to review competition in the healthcare marketplace, the CEOs of Aetna and Anthem and executives of the American Hospital Association told lawmakers about the benefits and perils of health plan mega-mergers.

Doctors’ group: Healthcare mergers not in patients’ ‘best interests’

http://thehill.com/policy/healthcare/252898-doctors-group-healthcare-mergers-not-in-the-best-interests-of-patients

The American Medical Association (AMA) is sounding the alarm about the proposed consolidations of four of the country’s largest health insurance giants.

Clear Health Costs: Insurers’ Payments Vary More than Hospital Charges

http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/53402?xid=nl_mpt_DHE_2015-09-05&eun=g885344d0r

Money Physician

‘No cost basis for the difference,’ says former hospital CEO

Will payer mergers stifle competition? Let us know (Poll)

http://www.healthcarefinancenews.com/news/will-payer-mergers-stifle-competition-let-us-know-poll?mkt_tok=3RkMMJWWfF9wsRohvKTIZKXonjHpfsX57u4rUa6zlMI%2F0ER3fOvrPUfGjI4JT8JrI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D

With Anthem set to buy Cigna and Aetna buying Humana, AHA executives sent a letter last week to the Department of Justice's antitrust division over concerns that consolidation among those largest payers could spell disaster for competition.

 

As Humana deal looms, a fight is brewing in Washington, D.C.

http://www.bizjournals.com/louisville/news/2015/09/01/as-humana-deal-looms-a-fight-is-brewing-in.html?ana=e_cinci_hc&s=newsletter&ed=2015-09-01&u=FAuoHGaGEPdmk4X6khnaiw045b16af&t=1441220686

A fight has been brewing all summer over insurance industry consolidation.

Most Health Insurance Co-ops Are Losing Money, Federal Audit Finds

The co-ops were created by Congress in an effort to increase competition and keep costs down. According to Daniel Levinson, inspector general at the US Department of Health and Human Services, 22 of the 23 co-ops lost money last year; most had fewer enrollees than had been originally predicted.

Aetna hit with counterclaims by ‘hotel-like’ hospital in $120M kickback lawsuit

http://www.beckershospitalreview.com/legal-regulatory-issues/aetna-hit-with-counterclaims-by-hotel-like-hospital-in-120m-kickback-lawsuit.html

Looking Glass and Money

Insurance megamergers limit nonprofit hospital negotiating power: 5 things to know

http://www.beckershospitalreview.com/finance/insurance-megamergers-limit-nonprofit-hospital-negotiating-power-5-things-to-know.html

OR Efficiencies

Reported premium increases are irrelevant for most marketplace consumers

Reported premium increases are irrelevant for most marketplace consumers

Health Insurance Claim Form

Do Medicare Advantage plans pay providers different rates than traditional Medicare?–ctd.

Do Medicare Advantage plans pay providers different rates than traditional Medicare?–ctd.

Drugs and Dollars

Contemplating health care with a focus on research, an eye on reform