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State Exchanges View All →

Millions of Consumers Opt for Non-Exchange Individual Health Plans

2 weeks ago

Millions of U.S. residents are forgoing the Affordable Care Act’s exchanges to purchase plans on the individual market for a number of reasons.

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Obamacare Exchanges Attracting Younger Customers, Insurers Say

3 weeks ago

As health insurance companies tally up the second year of enrollment of individuals from public exchanges under the Affordable Care Act, they are noticing younger customers that tend to submit fewer medical claims.

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Cancer hospitals participating in at least some exchange plan networks

4 weeks ago

Most specialized cancer hospitals say they participate in the narrow provider networks of some exchange health plans, but health insurers have not been shy keeping some cancer hospitals out, according to a new survey from consulting firm Avalere Health.

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Challenges Facing “Narrow” Provider Networks on the ACA Health Care Insurance Exchanges

1 month ago

The Driving Forces Behind the Trend Toward Narrower Networks.

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5 states where PPACA exchange silver plan costs soared

2 months ago

Active bargain hunters who were willing to change health plans could get good prices for coverage from the typical Patient Protection and Affordable Care Act public exchange-except in 5 states.

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Looking for Affordable Care Act activity for a particular state? Select here to find out what's going on:

Medicaid View All →

Sixteen states are now preserving Medicaid Pay Bump

1 week ago

Sixteen states and Washington, DC, are using their own money to keep Medicaid rates for primary care physicians at or near Medicare levels in 2015, but whether the raise has improved access to care is debatable, according to a new study.

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As States Expand Medicaid, Unpaid Hospital Bills Disappear

2 weeks ago

With more states expanding Medicaid coverage under the Affordable Care Act, hospital operators are reporting fewer unpaid medical bills and falling charity and uncompensated care expenses.

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Hospitals reap rewards of Medicaid expansion

3 weeks ago

Kaiser Family Foundation study: Multi-hospital system reports revenue up, charity care down in states that expanded the program.

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Economy boosts safety-net hospitals in states not expanding Medicaid

3 months ago

Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the Affordable Care Act.  But in some of the largest states that did not expand Medicaid, many “safety net” hospitals fared pretty well last year — better than in 2013 in many […]

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More States Lean Toward Medicaid Expansion

4 months ago

In accepting Indiana’s Medicaid Expansion plan, the Obama administration demonstrated its determination to increase the number of expansion states, even if it means waiving traditional Medicaid rules.

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Emerging Healthcare Models View All →

To succeed long-term, ACOs must increase consumer focus

2 days ago

Advocacy groups call for improved patient engagement, data access in Next Generation model

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The impact of accountable care: Origins and future of Accountable Care Organizations

1 week ago

he fragmented and misaligned state of the U.S. health care system has become a catalyst for payment and delivery system reforms.  The Accountable Care Organization (ACO) model is a key component of these reforms as these entities try to simultaneously restructure of the payment and delivery systems to incentivize higher quality, lower cost care.

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The Affordable Care Act’s Payment and Delivery System Reforms; A Progress Report at Five Years

2 weeks ago

In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions focused in three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms […]

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Insurance Covers Four In Five Visits To CVS And Walgreen Clinics

3 weeks ago

Insurance coverage for retail health clinics, once a cash-only proposition, now accounts for more than four in five visits reimbursed at such centers run by CVS Health (CVS) and Walgreens Boots Alliance (WBA).

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Health Insurance Shoppers Look to Limited Networks to Save Money

1 month ago

In all the turmoil in health care, one surprising truth is emerging: Consumers seem increasingly comfortable trading a greater choice of hospitals or doctors for a health plan that costs significantly less money.

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Insurers View All →

Value-Based Care May Drive Aetna Bid For Cigna Or Humana

1 week ago

No matter whether Aetna makes a run at rival health insurers Cigna (CI) or Humana (HUM), the coming consolidation among those picking up the tab for medical care will continue thanks in part to the move away from fee-for-service medicine to value-based care and population health.

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Are health plans with high deductibles becoming more popular?

1 week ago

Employers struggling to pay for workers’ health coverage can slow annual spending by about 5 percent by switching to high-deductible health plans, but the burden likely will fall on patients and health care professionals who’ll be expected to pick up the slack.

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Assurant Health to be sold or closed

3 weeks ago

With Milwaukee-based Assurant Health continuing to bleed red ink, its parent company announced in a Tuesday news release it will either sell the health insurer or exit the health insurance business.

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Here’s why carriers are forced to sink or swim in a post-PPACA market

1 month ago

The traditional healthcare business is fading into the sunset, along with its complex product structures, incomprehensible reimbursement models, and confusing industry jargon. A new day is dawning, and opportunities abound for the players that are prepared to pursue them.

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Insurers show greater compliance with medical loss ratio

2 months ago

Rebates that insurers owe patients are dropping, Commonwealth Fund finds

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