Four ways to thrive in the midst of change

Sohil Goorha

Though the deadline for complying with significant reforms of the Affordable Care Act has come and gone, payer organizations across the country are still adapting to the newfound complexities of their evolving industry.

The hidden segment

Shiv Gupta

With the first healthcare exchange open enrollment period concluded, savvy health plan marketers are spending much of their time and resources sifting through enrollment data hoping to gaint insights. However, this is a new world for plan providers, and most current marketing plans and sales strategies were developed for commercial and Medicare sales.

Feature Video

President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.


Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

If all goes according to plan, next year many Arkansas Medicaid beneficiaries will be required to make monthly contributions to so-called Health Independence Accounts.

The diabetes and obesity epidemics mean more Americans may suffer from heart disease before they turn 65, challenging payers to craft better intervention models that help prevent serious cardiovascular events and increased spending on acute care.

It's a chilling reality often overlooked in annual mortality statistics: Preventable medical errors persist as the number three killer in the U.S. and the source of great waste.

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After taking losses of $40 million over three years, BlueCross BlueShield of Western New York is withdrawing from the Empire State's Medicaid managed care program in six of its eight counties of operations.

After one of its worst years ever, one Blue Cross company is banking on an insider and native son to lead a comeback.

In a region dominated by one insurer and teeming with health systems, accountable care models are gaining provider acceptance but still accumulating evidence.

After quietly building a small insurance unit, one of the nation's largest health systems is launching a new health plan brand that could pose more competition for established insurers.


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