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State Exchanges View All →

Narrower Doctor Choices Coming For Obamacare And Employer Plans

1 day ago

As health care costs rise a bit faster than recent years, look for more health plans offered by employers and on public exchanges under the Affordable Care Act to pare their lists of doctor and hospital choices for 2016.

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Highmark Is Latest to Trim Offerings Under Health Law

2 days ago

Insurer retrenches amid losses, focusing on plans that have more limited choices of providers.

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NOT IN A SILVER PLAN? YOU PROBABLY PAID TOO MUCH FOR THAT DOCTOR VISIT.

2 days ago

Over 2 million consumers enrolled in the federal insurance exchange are not receiving the Affordable Care Act’s cost-sharing reductions (CSRs), even though they’re eligible.

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Number of Narrow Network Health Plans varies by state

1 week ago

As narrow networks tied to the Affordable Care Act continue to be a hot topic of debate, a new report highlights where in the country these controversial plans are most common.

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Increased Competition on HealthCare.gov Helped Constrain Premiums

1 month ago

U.S. residents who enrolled in health coverage through the federal exchange had a broader choice of plans in 2015 than they did in 2014, which helped to constrain premium cost growth, according to an HHS report released Thursday.

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Medicaid View All →

Dynamic Vision Is A Cornerstone Of State Payment Reform Initiatives

1 month ago

Faced with rising health care costs, states are designing and implementing payment reforms that fundamentally transform how the health care market provides and pays for services. Two states in particular, Ohio and Oregon, have developed an overarching vision to guide their multi-payer payment and delivery system transformations.

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Carriers Must Weigh Rewards, Risks In New Medicaid-Expansion States

1 month ago

While state leaders might have a strong interest in covering a larger percentage of their poor, political, fiscal and ideological differences often limit what can be done.

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Obamacare’s Medicaid Enrollment Explosion: A Looming Fiscal Nightmare For States

1 month ago

Across the country, governors and state lawmakers have circled “2017” on their calendars. This is the first year that the enhanced federal funding for Obamacare’s Medicaid expansion starts to fade away and the fiscal pain soon coming to states may be even worse than anticipated.

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Hospitals pay big price for lack of Medicaid expansion

1 month ago

But providers in expansion states reaping benefits.

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Medicaid Enrollment surges, stirs worry about State Budgets

2 months ago

More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years.

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Emerging Healthcare Models View All →

ACO operator Collaborative Health Systems says partners saved millions

1 week ago

Nine ACOs that partner with CHS generated $27 million in the Medicare Shared Savings Program.

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Is Walgreens looking for retail clinic exit?

2 weeks ago

An agreement between Providence Health & Services and Walgreens Boots Alliance could signal that the retail drugstore is looking to get out of the healthcare clinic business.

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ADP and USI Partner to Create Innovative Private Exchange Solution

4 weeks ago

ADP and USI Insurance Services, a leading insurance brokerage and consulting firm, are partnering to create a Private Exchange that offers employers a broad range of health benefits plan options.

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ACOs Appear Unable to Incentivize Physicians to Limit Costs

1 month ago

Practices in affordable care organizations (ACOs) provide a slightly higher compensation for quality when compared with practices at large, suggesting that the incentives for ACOs may not be strong enough to encourage practices to change physician compensation policies.

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Health insurer CDPHP saves $20 million with patient-centered primary care program

1 month ago

Health insurer CDPHP saved $20.7 million in 2014 through a program focused on improving primary care.

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Insurers View All →

Self-Funded Pharmacy Plans Becoming More Popular Among Large Employers

16 hours ago

UBA Survey Finds Self-Funded Pharmacy Plans Have Increased Nearly 30 percent in Five Years.

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For Health Insurance Startup Oscar, Cute Ads Only Go So Far

2 days ago

Oscar has hundreds of millions in funding. Now it needs customers.

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Health Insurer Mergers Signify Shift in Health Care Marketplace

2 weeks ago

The federal government is becoming one of the insurance industry’s biggest customers.

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A Change To Out-Of-Pocket Health Insurance Limits Irks Employers

2 weeks ago

One of the health law’s key protections was putting a cap on how much people can be required to pay out of pocket for medical care each year.

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The Cadillac Tax: U.S. Corporations On A Collision Course With An Escalade-Sized Expense

3 weeks ago

The Cadillac Tax got its name because Cadillacs are luxurious and expensive, not because they are huge and made in Detroit. But the annual 40% excise tax on employer-sponsored health plans with annual premiums exceeding $10,200 for individuals or $27,500 for a family starting in 2018 is anything but luxurious.

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