Rose Meltzer
FierceHealth
Washington, DC, United States
Contact Rose
Discover and connect with journalists and influencers around the world, save time on email research, monitor the news, and more.
| Recent: |
|
| Past: |
|
Past articles by Rose:
Social determinants became mainstream in 2018, but it can't be just a fad
Payers, providers, and startup companies tackled food insecurity, reliable transportation, affordable housing, and more this year. But much remains to be done in 2019 and beyond. → Read More
Federal judge satisfied with CVS' plan to keep Aetna operations separate pending approval
Judge Richard Leon seems satisfied with how CVS is keeping its distance from Aetna while he reviews whether the merger's terms are in the public's interest, though he would like additional oversight. But Leon also blasted the DOJ as “tone deaf unnecessarily defensive." → Read More
Texas judge strikes down ACA as unconstitutional, but long legal path remains
A federal judge ruled Friday night that the entire Affordable Care Act is unconstitutional, casting doubt on the healthcare law on the eve before the end the final day of 2019 open enrollment. The ruling is likely to spur an appeal and could wind up in the Supreme Court. → Read More
Payers see consumerism and data analytics as top priorities in 2019. Most aren't prepared to deliver
Value-based care initiatives will make smart use of data and customer satisfaction more important than ever next year, according to a new survey from consulting firm North Highland. However, most payers aren't yet sure how they can distinguish themselves to achieve those goals. → Read More
CommonWell-Carequality beefs up data sharing, but some providers remain disconnected
CommonWell and Carequality’s connection last month eliminated a major barrier to interoperability, making it easier for provider organizations to connect with one another. But many providers still haven’t gotten out of the gate, according to a new report from KLAS. → Read More
Millions of citizen children could lose coverage due to public charge rule, study says
A new analysis from the Urban Institute says many immigrant families could drop their citizen children's Medicaid and CHIP coverage out of fear due to the proposed public charge rule, reversing massive coverage gains. → Read More
AHIP, CMS, NQF formalize collaborative to align quality measures across payers
In this public-private partnership, the organizations develop "parsimonious" sets of measures that payers of all kinds can use to create their own quality metrics. → Read More
New Medicare marketing guidelines raise the specter of past predatory sales tactics
The need for Medicare marketing regulations was crystal-clear 10 years ago. But a slew of changes to CMS' Medicare marketing guidelines this year expanded what plans can do at educational events, in providers' offices and more. Do these revisions create room for growth or opportunities for manipulation? → Read More
Big 8 health insurers rake in more than $7B in Q3, setting up strong finish to 2018
Most health insurance companies profited handsomely by the end of this past quarter. Aetna, Molina and UnitedHealth performed especially well, albeit for varying reasons. → Read More
Jury pins Aetna with $25.5M verdict for denying cancer treatment
The insurer refused to cover "the best and only treatment" for an Oklahoma woman's stage 4 cancer. With their verdict, jurors said it's up to Aetna to fix the broken healthcare system. → Read More
HHS planning new bundled payment models with mandatory participation on the table
While both voluntary and mandatory bundled payment models have the potential to advance value-based care, mandating participation provides HHS the most information about what works, said Secretary Alex Azar. → Read More
CMS proposes additional oversight of ACA exchanges, including abortion coverage
The agency wants to prevent people who are enrolled in Medicare from also enrolling in exchange plans, and to bill consumers separately for the portion of premiums that would go toward abortion services. → Read More
Humana reports $901M in Q3 earnings, attributing growth to prevention
Making the most of technology and addressing social determinants of health improved the customer experience for members and cut costs, said CEO Bruce Broussard. → Read More
Big wins for Medicaid: Voters in Idaho, Utah and Nebraska approve expansion
Medicaid expansion was on the ballot in three historically Republican states, and voters came out in support of the measure in all three. Nebraska, Utah and Idaho voted to expand the program, while Montana voted down a measure to increase tobacco taxes to continue funding expansion. → Read More
California's racial disparities in coverage declined post-ACA, study finds
By 2016, the uninsured rates among the Golden State's white, black and Asian populations were nearly equal. But other disparities persist, and all of these rates are highly policy-dependent. → Read More
American Hospital Association plans to sue CMS over final site-neutral payment rule
The hospital organization announced its intent to sue the administration for overstepping its boundaries just hours after the CMS released a rule implementing new site-neutral payments for clinic visits. However, physician groups applauded the agency for advancing value. → Read More
Hospitals aren’t the only ones with price variation. New research shows payers have large discrepancies, too
Negotiated prices, even for the same service at the same hospital, vary widely depending on the payer, the authors found—and it could be a sign that the market isn't working the way it should. → Read More
CMS proposed rule expands telehealth for Medicare Advantage plans, beefs up payment audits
A rule proposed late on Friday would enact several provisions of the Bipartisan Budget Act, including one that would allow MA plans to offer more telehealth benefits than traditional Medicare. → Read More
Payer Roundup—North Carolina to begin Medicaid managed care; Anthem taps Google whiz for AI
Through a recently approved §1115 waiver, North Carolina will begin transitioning its Medicaid population into managed care, with custom programs for certain populations. Plus, Anthem is bringing on Google's former head of search products to work on AI. → Read More
Oscar heads into 'strong' individual market looking to lure members with consumer-centric onboarding
By functioning like a tech company—in its use of digital tools and operationally—the startup insurer hopes to provide a simpler, more personalized experience for consumers. That starts with the company's interactions during open enrollment, Sara Wajnberg, senior vice president of product at Oscar, tells FierceHealthcare. → Read More