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State Exchanges View All →

Health Insurance CO-OPs Fight Insolvency

5 days ago

The U.S. Department of Health and Human Services announced in December that two struggling health insurance cooperatives were given emergency solvency loans.

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More PPACA exchange users get premium subsidies

4 weeks ago

The U.S. Department of Health and Human Services (HHS) says at least 4 million people are set to have private exchange plan coverage in place Jan. 1, 2015.

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Obama Administration to Investigate Insurers for Bias Against Costly Conditions

1 month ago

The Obama administration said Monday that it would investigate prescription drug coverage and other benefits offered by health insurance companies to see if they discriminated against people with AIDS, mental illness, diabetes or other costly chronic conditions.

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Obamacare Co-Ops Cut Prices, Turn Up Heat On Rival Insurers

1 month ago

Co-Ops are offering low premiums that are upsetting so-called “legacy” insurance plans like Blue Cross and Blue Shield affiliates that have traditionally dominated insurance markets.

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Aetna says demand surging for individual Obamacare plans

2 months ago

With the deadline approaching for individuals to renew healthcare plans purchased on HealthCare.gov, Aetna has begun to see a surge in customers for 2015, the insurer’s new president said on Thursday during a meeting with analysts and investors.

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Medicaid View All →

Medicaid Reimbursement Increases Under ACA Boost Access

3 days ago

A temporary increase in reimbursements under the Affordable Care Act for primary care physicians who treat Medicaid beneficiaries resulted in easier access to appointments, according to a study published Wednesday in the New England Journal of Medicine.

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As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

4 weeks ago

Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

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Medicaid Rolls Surge Under Affordable Care Act

1 month ago

Idaho, Georgia, and North Carolina did not opt to expand their Medicaid programs as part of the Affordable Care Act, but all have seen substantial enrollment increases in state health insurance.

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Medicaid expansion news from 4 states

2 months ago

Recent news reports describe the challenges of reforming Medicaid in California, Indiana, Montana and Pennsylvania and what these states are doing in response.

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How Health Law’s Medicaid Enrollees Strain the System

2 months ago

Many low-income Americans have gained coverage, but their numbers are straining some health-care systems.

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Emerging Healthcare Models View All →

Accountable Care Organizations: Like HMOs, but Different

6 days ago

In pursuit of greater efficiency in the United States health system, public programs and private insurers have begun to pay some hospitals and physicians differently. These new payment models take many forms, but they all impose greater responsibility for cost control and quality improvement on providers and bear some resemblance to failed health care financing […]

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Trinity Health to expand risk-based care with Heritage Provider Network

1 week ago

Trinity Health, an 86-hospital Catholic system based in Livonia, Mich., has signed a definitive joint venture agreement with Heritage Provider Network to advance its strategy of coordinating care for specific groups of patients.

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PCMHs Have No Effect on Medicaid Patients’ Acute Care Use

2 weeks ago

A study of Louisiana primary care clinics that have been certified as patient-centered medical homes (PCMHs) found no effect on acute care use among the Medicaid population and little reduction in cost or primary care use.

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John Muir forms new accountable care organization with Health Net

2 weeks ago

John Muir Health and Health Net of California have agreed to work together to coordinate care for more than 9,000 patients in Contra Costa, Solano and Alameda counties.

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Humana Signs Accountable Care Deal with Banner Network

2 months ago

Humana recently entered into a new Accountable Care agreement with Banner Network Colorado (BNC), an integrated provider delivery network in North Colorado.

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Insurers View All →

Lavish ‘Cadillac’ Health Plans Dying Out as Obamacare Tax Looms

2 weeks ago

Large employers are increasingly putting an end to their most generous health-care coverage as a tax on “Cadillac” insurance plans looms closer under Obamacare.

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Obama Administration to Investigate Insurers for Bias Against Costly Conditions

4 weeks ago

The Obama administration said Monday that it would investigate prescription drug coverage and other benefits offered by health insurance companies to see if they discriminated against people with AIDS, mental illness, diabetes or other costly chronic conditions.

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Looking Outside the Government Box for Suitable Health Coverage

1 month ago

If you’re uninsured and want individual health coverage starting on Jan. 1, you’re mostly out of time, if you want to buy on the government marketplaces. Some individual plans are still available outside the marketplaces.

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Health insurance markets dominated by oligopolies before Obamacare

2 months ago

A select few health insurance companies control a large portion of the individual and employer markets in each state, a new report from the Government Accountability Office finds. But it’s unclear how Obamacare will affect those figures, as more insurers rush to give people more health plan options.

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Employers to stick with health plan designs in 2015; add wellness incentives

2 months ago

Very few employers are planning to make drastic changes to their group health benefit plans in 2015, opting instead to add incentives to workplace wellness programs in order to help hold down rising medical costs, according to survey data released on Wednesday.

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