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Insurance professionals need to use CDHPs


More and more, health insurance professionals who design consumer-driven and high deductible plans are using them personally, a trend that bodes well for their improvement. Read more »

UnitedHealth plots exchange market surge


Premiums for exchange plans in many states are set to increase anywhere from slightly to significantly, but there's new competitive pressure coming as the nation's largest insurer starts flooding markets. Read more »

Struggling Blue finds a new chief


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

Pennsylvania insurer's ACO marks hospital gains


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

Provider giant primes for health plan expansion


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. Read more »

Insurance services firm acquires HealthPocket


The healthcare tech boom continues, as one of the most-heralded consumer insurance comparison startups was acquired by an insurance services firm hungry for growth. Read more »

PBMs threaten sustainability of Medicare, Part D plans


Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive's spines. Read more »

Without Medicaid, hospitals may pay patient premiums


Uncompensated care was supposed to be a thing of the past, but it's persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option. Read more »

Employers, workers migrating to HSAs


Group plans are increasingly expanding their consumer-directed health plans with health savings accounts, after toying with lower deductibles and reimbursement account wrapping. Read more »

State plan association names new executives


One of the nation's largest health insurance advocacy groups is welcoming in a new chief executive, amid a tumultuous regulatory environment. Read more »

States have options to fill Medicaid reform gaps


Amid record enrollment in Medicaid and state concerns about the program's budgetary sustainability, the federal government is offering new financial support and policy options. Read more »

Regulatory power becomes center of insurance debate


In California, insurers and regulators are fighting for control of the post-reform insurance market. Read more »

As a rule, MCR regulations not negative for insurers


With federal rules governing health plan spending looking like they're here to stay, insurers are making inroads on compliance, although they will hope for possible tweaks in the future. Read more »

Pockets of group membership migrate to public exchanges


As Affordable Care Act exchanges bring health plans to previously uninsured Americans, there are also market segment transitions that could prove favorable for risk pools. Read more »

Blues continue march away from fee-for-service


Trying to help transition the American healthcare system beyond fee-for-service, Blue Cross and Blue Shield companies are starting to reach new reimbursement milestones. Read more »

UnitedHealthcare oncology incentive program generates savings


UnitedHealthcare's bid to change financial incentives for oncologists has led to some promising, though somewhat mixed results. Read more »

Cigna finds gains in physician collaboration


Joining its peers in touting accountable care, Cigna has met a fairly ambitious goal set two years ago, but more time is needed to test the strategy's sustainability. Read more »

Provider-owned plan tries for lean data methods


One regional insurer is using a new approach in provider network management, as it aims to tackle a laborious administrative process. Read more »

HIX network, PPO confusion sparks class action suit


One of the country's largest health insurers is being accused of having misleading information on doctor and hospital network participation for EPO and PPO plans sold in the state exchange. Read more »

Aetna sees promise in new heart disease diagnostic


With spending on diagnostics alone for cardiovascular disease likely to be a major challenge for insurers amid the baby boom wave, Aetna is turning to an emerging option as part of a strategy to avoid invasive tests and treatments. Read more »

Highmark health system inks affiliation deal to up oncology care


The insurer-owned Allegheny Health Network is partnering with a national cancer center to offer new therapies and trials in western Pennsylvania, a sign of heightening regional competition and the emergence of new models for pursuing innovative treatments. Read more »

Claims growth trends portend new spending challenges


The growth of total U.S. medical costs is slowing down, but one segment is expanding fast enough to catch insurers by surprise. Read more »

New HIPAA enforcer takes reigns


The Office for Civil Rights, the HHS division responsible for enforcing HIPAA, is slated to get a new director after the official departure of Leon Rodriguez. Read more »

WellCare reboots


As the final chapter of WellCare's fraud saga closes, the company is lining up new executives and trying to grow. Read more »

High court creates an opt-out of contraception mandate


Two years after upholding most of the Affordable Care Act, the U.S. Supreme Court has carved out a new religious exemption for employers, once again bringing women's health into the political fray and potentially adding new complications to group insurance. Read more »

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