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State Exchanges View All →

UnitedHealth to compete in just three ACA exchanges in 2017

3 weeks ago

UnitedHealthcare, in an effort to cut its losses in the individual market, will only compete in three states’ Affordable Care Act marketplaces in 2017: New York, Nevada and Virginia.

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Aetna Not Withdrawing From Any Health-Law Insurance-Exchange States

2 months ago

Insurer says it may expand into new geographies for exchange health plans.

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Humana to exit ACA exchanges in 2 states

2 months ago

Humana will not sell Affordable Care Act plans in Alabama and Virginia in 2017.

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Humana Says Obamacare ‘Product Exits’ Coming For 2017

2 months ago

Humana said it’s in the process of making several changes to turn the individual health insurance coverage it offers under the Affordable Care Act profitable, including leaving certain states.

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As UnitedHealth Bails On Obamacare, Rivals Look To Expand

2 months ago

News that UnitedHealthcare will scale back to just a “handful” of states where the insurer offers subsidized coverage on public exchanges under the Affordable Care Act hasn’t led to a domino effect for the insurance industry.

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Medicaid View All →

Hospitals Feeling Pinch in States That Don’t Expand Medicaid

1 day ago

While most hospitals have seen a stark decrease in uncompensated care costs related to the Affordable Care Act (ACA) and Medicaid expansion, some hospital groups have not substantially benefited from the change.

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CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

3 weeks ago

Major goals of CMS’ in revising the regulations were to align Medicaid and CHIP managed care requirements with other major health coverage programs.

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States save money with new Medicaid policies for incarcerated population

3 weeks ago

Three states’ initiatives to connect the justice-involved population to Medicaid coverage have produced savings and administrative efficiencies for their Medicaid programs, according to a new issue brief.

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States’ Medicaid demonstrations require robust evaluation

1 month ago

Medicaid expansion waivers carry profound policy implications.

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Major Medicaid managed-care reforms hand the ball to states. Will they run with it?

2 months ago

The key word defining the first significant federal changes to Medicaid managed care in 14 years is “flexibility”—for states, that is.

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Emerging Healthcare Models View All →

Geisinger Medical Homes For Commercially Insured Consumers Reduced Care Costs By 9%

2 days ago

Commercially insured adults enrolled in a Geisinger Health System patient-centered medical home (PCMH) from 2008 through 2013 had costs of care about 9% lower than costs of consumers not enrolled in a PCMH.

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Aledade rolls out 3 new ACOs, expands another

2 days ago

To ring in its second anniversary, Bethesda, Md.-based Aledade — a company that helps independent physicians participate in value-based care — announced Wednesday three new accountable care organizations and the expansion of another.

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Boeing partners with MemorialCare to offer healthcare direct to workers

2 days ago

Aerospace giant Boeing Co. has established a preferred partnership with MemorialCare Health System to offer most of its Southern California employees a health plan option that eliminates much of the role of a traditional insurer.

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Tracking the Transition to Value-Based Payment in Healthcare

2 days ago

More than 58% of healthcare payers’ businesses have already shifted to full value-based reimbursement models, a 10% increase since 2014.

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MedAxiom and Magellan Health Launch Cardiovascular-Specific Accountable Care Initiative

3 weeks ago

National initiative supports cardiovascular practices as they implement new programs to improve outcomes and patient satisfaction, and reduce costs.

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Insurers View All →

Anthem ACOs save providers $14.8M in one year

2 months ago

Care coordination efforts initiated through Anthem’s accountable care organizations (ACOs) saved four medical groups nearly $15 million over the course of one year.

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Centene profiting from ACA plans, Medicaid expansion

2 months ago

UnitedHealth Group may be abandoning most of the Affordable Care Act’s insurance exchanges due to steep losses. But Centene Corp. is doing just fine in the marketplaces.

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UnitedHealth Quits More Obamacare Markets, Exiting Kentucky

2 months ago

UnitedHealth Group Inc. will pull out of Kentucky’s individual marketplace for Obamacare plans, bringing to 26 the number of states the health insurer is quitting next year.

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Insurers air risk-adjustment concerns in meeting with feds

3 months ago

CMS open to tweaking program, but skeptical of some stakeholder proposals.

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