Payers must change dynamic with providers to survive in the post-Affordable Care Act world

Suzanne Cogan, Orion Health

Finding the path to success in the post-Affordable Care Act world of healthcare represents a great opportunity and challenge for payer organizations. Part of that journey is changing the relationship dynamic between payers and providers.

Affordable Care Act rate stabilization program results should guide strategy for 2016

Lisa DiSalvo, Altegra Health

Earlier this year, the Centers for Medicare and Medicaid Services released the results of the first year of the reinsurance and risk adjustment provisions of the Patient Protection & Affordable Care Act.

Feature Video

The Obama Administration recruited Seattle Seahawks quarterback Russell Wilson and cornerback Richard Sherman to the game of selling the Affordable Care Act.

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.


We have merged Healthcare Payer News into Healthcare Finance.
You can now experience the latest business developments in healthcare
and payer-centric topics --all on the same platform.

A warm welcome from the entire Healthcare Finance team!

Henry Powderly
Healthcare Finance

The merger also needs the green light from 23 other states and ultimately the Department of Justice, which is also weighing the proposed $38.5 billion consolidation of Aetna and Humana.

Template includes coverage examples that demonstrate cost sharing amounts.

The Internal Revenue Service doesn't tell tax filers that their low and moderate incomes likely mean their households qualify for Medicaid or subsidies to buy coverage on the insurance exchanges. 

Exchange websites that do not call attention to the quality of medical care in a plan are more likely to see consumers selecting the low-cost alternative, according to Health Affairs.

The federal and state marketplaces would do well to nudge consumers toward health plans that result in the best fit for the individual, according to a Health Affairs report.

The total 3.05 percent rate is less than the total 3.55 percent CMS proposed in February.

While healthcare provider directories have always been hard to maintain, new regulations can mean costly fines if insurers fail to keep accurate, up-to-date information on the physicians who are in their health plans.

UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.

Advertisement. Closing in 15 seconds.