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Did the Chinese government hack Anthem?


In the guessing game and investigations of the attack on Anthem Blue Cross and Blue Shield, one early hypothesis blamed eastern European cyber mafia. Now, new evidence points further east. Read more »

Long road ahead for Mass HIX


For the state that pioneered the public insurance exchange only to see dysfunction during the first ACA open enrollment, there are still many miles to go. Read more »

In Texas, Aetna takes on doc-owned hospital profiteering


Trying to recover $120 million, the nation's third largest insurer is fighting back against an alleged scheme of kickbacks, out-of-network billing and the marketing of supposedly luxurious healthcare. Read more »

IRS clarifies health plan fee exemption, prepares for Cadillacs


The Internal Revenue has released temporary regulations and proposals for the health "9010" insurance fees required by the Affordable Care Act. Read more »

Investing in obesity battle, Humana may give Weight Watchers new life


In an effort to hone another tool to treat obesity, Humana is partnering with a struggling but well-regarded brand that helped define American weight loss. Read more »

Bayou Blues seek new CEO to continue healthy momentum


The retiring leader of Louisiana's largest insurer leaves a legacy of growth and action on issues like obesity. But the next CEO will face the legacy uninsurance problem and a population beset with chronic disease. Read more »

For some middle class HIX consumers, time to pay back subsidies


Roberta and Curtis Campbell typically look forward to tax time. Most years, they receive a refund. But this year the California couple got a shock: they owe the IRS more than $6,000. Read more »

Aetna bets on startup at intersection of lifestyle, disease


After an experiment with its employees, Aetna is offering large employers a personalized engagement service to help workers mitigate one of modern life's most pernicious health conditions. Read more »

Another site vies in the consumer health transparency space


Adding to the list of healthcare price comparison tools is a consumer website with one of the largest databases yet, although it is perhaps not enough to end the Dark Ages of healthcare transparency. Read more »

California psychiatrist, patient satisfaction guru takes Geisinger helm


One the nation's smaller but more influential integrated health systems has a new chief executive, in time for both fine-tuning and new ventures. Read more »

CMS insurance regs push bar for consumer access, choice


This year's open enrollment may be mostly over. But for 2016 and beyond, insurers should prepare for evolving regulations on everything from premium increases to drug formularies. Read more »

Seniors pass on Medicare obesity help


In the farming town of Exeter, deep in California's Central Valley, Anne Roberson walks a quarter mile each day to her mailbox. Her walk and housekeeping chores are the 68-year-old's only exercise, and her weight has remained stubbornly over 200 pounds for some time. Read more »

Medicaid programs struggle to meet dental demand


When Pavel Poliakov's small clothing shop in a picturesque college town closed last year, he felt lucky to be able to sign up for Medicaid just as Colorado expanded the program under the new healthcare law. Read more »

Catholic hospital giant buying small health plan


The nation's largest nonprofit health system is quietly getting into the insurance game under the auspices of population health. Read more »

Medicare Advantage 2016 rate season begins


Medicare Advantage reimbursement and regulatory changes are coming, along with new probes into risk adjustment practices that could lead to settlements and clawbacks. Read more »

With tax woes, special enrollment extends shopping


The federal government is extending the exchange sign-up deadline, due to concerns about tax season confusion and subsidy mistakes for some 800,000 Americans. Read more »

Health reform losses for smaller for-profit insurer


While the new health insurance market is about as profitable as the pre-reform era for some large insurers, that is not the case for those like Assurant. Read more »

South Carolina Blues well capitalized, diversified


South Carolina might be an unlikely place from which to run a small healthcare empire, but the state's oldest health insurance company is doing just that. Read more »

Why the wellness model must evolve anew


Corporate wellness skeptics are out early this year, arguing that the data is squarely on their side and that simpler, laissez faire approaches could be more effective. Read more »

Skirmish over PPO access, charges leads to lawsuit


Once again, insurance practices on cost-sharing and reimbursement for out-of-network providers and PPOs are ending up in dispute, with backlash from providers and customers. Read more »

Boeing's ACO-esque plans taking flight


Workers at Seattle's largest employer are signing up in droves for new ACO health plans led by regional health systems, who see the model as ripe for growth. Read more »

Pressure mounts to overhaul military health plans


The U.S. Department of Defense can look like a benefits company "that occasionally kills a terrorist." The agency has to overhaul its healthcare contracting, especially TRICARE, according to advocates. Read more »

UHG upgrades mobile app, looks to food rewards


The nation's largest insurer is making leaps in the journey of consumer-driven healthcare, improving its digital offerings and investing in new member incentives. Read more »

Figuring out if a doctor is in network harder than it should be


"Is this doctor in my insurance network?" is part of the litany of questions asked when considering whether to see a particular doctor. Unfortunately, the answer may not be a simple yes or no. Read more »

Will transparency make certificate of need moot?


After decades of research showing at best mixed benefits, certificate of need programs are starting to look antiquated and deleterious in the age of consumer-driven healthcare. Read more »

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