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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 »

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 »

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