All news headlines

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 »

The coming MCO regulatory overhaul

Federal officials are preparing the first major regulatory update to Medicaid managed care in a decade, promising to challenge insurers but also fix long-standing issues and offer routes to business standardization. Read more »

Voters reject idea of ACA 'missing piece'

Health insurers in the nation's largest market are breathing a collective sigh of relief after escaping a new rate review system, but they may have to fight the battle again. Read more »

Insurance exec wins chance to lead reform as Governor

How will a long-time insurance manager fix the crisis in a state with some of the most expensive and advanced healthcare on the planet? Read more »

Wellness incentives at a crossroads

A federal court is letting a wellness program's financial penalties take effect, but is considering the question of how much is too much, leaving corporate America and insurers waiting. Read more »

Junk food and exercise, where prevention hits the ground running

In the quest for population health, lifestyle interventions for diabetes may pose the biggest rewards and most vexing challenges. Some are making progress, however. Read more »

Watchdog plans a year of payer probes

Already big and still growing, the U.S. healthcare system in 2015 will be scrutinized inside and out for signs of financial problems, the federal government's health investigator promises. Read more »

Girding for consumerization, Aetna buys an HIX

Looking out at the transition to retail insurance and inward to its own efforts to develop consumer-focused services and technology, Aetna is investing in its own private benefits exchange.  Read more »

Amid duplication concerns, feds back off plan ID system

All HIPAA-covered health organizations, and especially insurers, have been handed a small victory in the war of administrative simplification, as federal regulators once again back off a policy change long in the making. Read more »

Who moves first in price transparency, providers or payers?

Embracing consumer-oriented healthcare, some providers are voluntarily adopting price transparency, while some insurers balk at proposed mandates to disclose their rates. Read more »

Small businesses looking for greener benefits pastures

For now at least, the employer mandate isn't going anywhere. But small businesses are flocking to a new market, leaving behind traditional models. Read more »

Providers mull risks, benefits of launching health plans

Every organization looking at someone else's business thinks there is a tremendous amount of waste, and believes they could do it better if given the opportunity. This is just as true in healthcare as any other industry. Read more »

Co-op looks beyond FFS from get-go

Many health insurers have spent close to a century operating under fee-for-service and are now changing course. Some new payers founded post-health reform, however, are trying to hit the value-based ground running. Read more »

A good night's sleep as untapped market

Of all the things to try to build a better business for in healthcare, the nation's fourth-largest Blue Cross insurer is focusing on one of life's most crucial processes. Read more »

The EEOC suing wellness programs

Encouraging employer programs for health and prevention with one hand, the federal government is trying with the other hand to stake out a limit to what can be required of employees. And it's getting a bit fractious in the wellness space. Read more »

COB TBD: Paying for the right member

Figuring out when members are covered by different types of insurance can be a struggle, or not even possible. It's a source of waste and confusion that some insurers are trying to root out. Read more »

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