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Uncertain future for Medicaid private option


The Medicaid private option policies designed to insure low-income individuals through a more market-based system is showing early signs of success, but also hurdles. Read more »

How are HIXs going to sustain themselves?


Federal health officials and state exchange leaders may be pleased with enrollment and plan choices in many places, but long-term financing is a puzzle yet to be solved. Read more »

Regulatory probe hits network adequacy


Provider network controversies from the first Affordable Care Act enrollment are coming back to bite two large Blues in the second open enrollment, while raising questions about responsibility for consumer confusion. Read more »

Large duals demo faces backlash


California's experiment aimed at moving almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance. Read more »

Humana boosts retail strategy with new payment option


Want to pay your health plan premiums while picking up medications, buying some batteries (or maybe a piece of chocolate) and getting a free cholesterol screening? Humana is betting that retail convenience will support its individual membership business. Read more »

California HIE rounds out executive team for longhaul


A new payer-led patient information exchange in California is getting ready to hit the ground running. Read more »

The shrinking employer plan market


Not only are employers prone to switching their health plans, but more are ending their group health benefits altogether, a sign of the growing importance of the individual market. Read more »

HIX finds an avatar for consumer education


One of the greatest concerns among patient advocates, regulators and insurers alike is that buying and using a health plan may be too complex a task for some consumers. One state exchange is hoping it found a scalable solution. Read more »

Cigna tries gamification for wellness


Americans working to improve their eating and activity habits often fail, and not for lack of investment by employers, insurers and wellness vendors. Despite, or perhaps because of those challenges, Cigna is taking another crack at the problem. Read more »

Fiscal headwinds for nation's top-ranked plan


The nation's highest rated health plan is going through some growing pains and trying to make it to 2015 intact. Read more »

Hidden premium turbulence in national HIX outlook


Nationally, the new individual exchange market seems competitive going into its second year, with a variety of plans and reasonable premium increases. At the local level, though, consumers may experience some havoc. Read more »

HealthCare.gov launches with few glitches, so far


By most accounts, the federal marketplace that handles enrollment for 37 states is running well, but there are still uncertainties, notably millions of confused American consumers.  Read more »

Employer-sponsored insurance costs keep ticking up


Though slower than the worst spikes of the last decade, American companies and their workers continue to see healthcare costs increases, putting pressure on insurers to respond with new exchanges and plan designs. Read more »

Co-branding plans offer a wider reach


More insurers are finding benefits in marketing new health plans with regional providers, as a way to leverage prominent brands, make networks more accessible and also create potential competitive threats. Read more »

The Luck Plan: reaching reluctant young adults


In the Affordable Care Act's second enrollment period, insurers and exchange will again try to lure the young adult demographic, a challenge that will test risk adjustment policies and the best minds in marketing. Read more »

A case for investing in mental wellness


With new essential health benefit rules, some insurers are starting to take a more proactive approach to mental and behavioral health. Read more »

UHG reorgs the executive team


Taking stock of its diversification strategy, the nation's largest health insurer is creating a new enterprise oversight unit, moving around some key leaders and saying goodbye to others, all before a big enrollment push. Read more »

Blues get their VC on


Large national insurers have gotten lots of attention for investing in new technology and acquiring startups, but as it happens the Blues are making some of the biggest waves in the digital health space. Read more »

Prepare to waste more money on ICD-10


A new Republican majority focused on curbing regulation may give the healthcare industry the opposite of what most are looking for: uncertainty. Or they could turn to a fairly simple option to help the stakeholders long resistant to ICD-10. Read more »

Integrated delivery and HMO giant eyes expansion


The California-based nonprofit health system and HMO Kaiser Permanente is hustling and bustling this year. Read more »

Tit for tat in exchange pricing


Public exchange shoppers will have more choices this open enrollment period, and in some places, they're being courted with affordability, as insurers try to draw both first-time buyers and membership from rivals. Read more »

Speciality pricing opens insurers to discrimination charges


Pre-reform underwriting approaches for speciality medications like HIV/AIDS drugs are not going to fly in the new health insurance market, as regulators and patient advocates intervene to challenge a range of practices. Read more »

Fight against ACA subsidies may have a chance


What was once thought to be a Hail Mary attempt by Affordable Care Act opponents is now starting to look like a clear pass with a chance of being caught. Read more »

Consumers vex wellness movement


Despite backlashes against health screenings in corporate wellness programs, many Americans are open to a trade-off if it saves them money, though not necessarily lifestyle changes. Read more »

Claims databases gain traction as transparency tool


More and more states are turning to all-payer claims databases to try to bring the ideas of transparency and shopping to reality. Read more »

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