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Tuesday, Dec 15 2015

Full Issue

Nation's Largest Insurers Allow Researchers 'Unprecedented' Look At Prices They Pay For Medical Services

Aetna, Humana and UnitedHealth will provide information to researchers on claims data for an estimated 88 million people and $682 billion in health care bills.

Three of the nation鈥檚 largest insurance companies 鈥 Aetna, Humana and UnitedHealth 鈥 have let researchers have a look at the negotiated prices they pay for services and procedures like C-sections, MRIs and hospital stays. All told, we鈥檙e talking about claims data for 88 million customers, some $682 billion of healthcare bills. (Gorenstein, 12/15)

Meanwhile, an Ohio insurer opts to leave the health law marketplace and abandon the Kaiser Permanente model -

HealthSpan, the insurance arm of Catholic health system Mercy Health, is getting rid of its medical group and halting sales of Affordable Care Act policies just two years after acquiring Kaiser Permanente's Ohio subsidiary.The move represents a failure of one health system trying to replicate the much-heralded Kaiser model of healthcare, which integrates the payment and delivery sides. HealthSpan has been severely hurting the finances of Mercy Health, and executives felt they had to address 鈥渢he operational challenges,鈥 according to recent financial documents. (Herman, 12/14)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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