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Making medicines more effective


If the time for precision medicine is now, could the massive databases of health and drug plan claims systems be a starting point? Read more »

Cigna, Humana's Q1 come in slightly behind bigger peers


Though it's been a booming first quarter for the major for-profit health insurers, the smaller two of the big five are not booming quite as much. Read more »

Centene keeps growing with government health programs


Medicaid managed care specialist Centene nearly doubled its quarterly profit, wrapping its arms around more and more members while adding fuel to rumor fires about the next wave of takeovers. Read more »

Record high stock as Aetna posts healthy first quarter


Aetna is again showing that the new insurance market, along with the business of health reform, can be profitable. Read more »

Assurant wants out of the health insurance business


For sale: Historic health insurance company with one million customers, $2 billion in revenue, some recent losses and mixed customer satisfaction, plus a modestly profitable voluntary benefits unit. Read more »

Billing gauntlet thrown for ACOs and provider-owned plans


For both insurers seeking value and health systems pursuing all things integration, there is a huge conundrum waiting for an intervention: the hospital facility fee. Read more »

Inside Aetna's accountable care strategy


"We're comfortable being known as the health plan that wants to put health systems in the business of selling insurance." Read more »

Medicaid's tension: Getting corporate giants to do right by the needy


Lynda Douglas thought she had a deal with Tennessee. She would adopt and love a tiny, unwanted, profoundly disabled girl named Charla. The private insurance companies that run Tennessee's Medicaid program would cover Charla's healthcare. Read more »

Blue Shield exec under fire for using corporate card at Hollywood clubs


Blue Shield of California is embroiled in a fight with a former executive over $100,000 spent on Hollywood nightclubs and other dubious items. Read more »

Blues launch private Medicare exchange


Blue Cross and Blue Shield companies are setting up their own insurance exchange for retirees switching to individual Medicare plans, a bid to secure lifetime customers from in a new population of seniors. Read more »

Lots of consumers may have been shorted on HIX subsidies


Thousands of families with a disabled or deceased parent may have received a lower subsidy than they deserved to buy health coverage through the federal insurance marketplace as a result of a calculation error by the federal government. Read more »

States get a warning: Expand Medicaid or risk hospital funds


Add Tennessee and Kansas to the list of states that have been warned by the Obama administration that failing to expand Medicaid under the Affordable Care Act could jeopardize special funding to pay hospitals and doctors for treating the poor. Read more »

Nationals seize contract opportunity amid Nebraska Blue dispute


It's a network war with Midwest manners, but Nebraska's largest insurer and health system still have miles to go before a resolution. The impasse may be hurting one organization more than the other. Read more »

Rate hikes for grandfathered plans raise ire


Consumer advocates and an activist insurance commissioner in California are renewing a push for premium review authority, while the state exchange is moving ahead with its own version of active purchasing. Read more »

Humana scoops up home medicine company


For Humana, the national insurer with the most Medicare Advantage members, retail health clinics are out of the integration strategy, but home care is very much in. Read more »

BCBS Illinois grows ACOs amid flurry of hospital M&A


Illinois' largest health insurer is building out its accountable care network, even as some of the health system partners are consolidating. Read more »

Hospital gives patients, payers a warranty


Taking a cue from car manufacturers and cell phone companies, some providers are starting to see value in guaranteeing a standard for quality and costs. Read more »

Few consumers using quality, price information in healthcare choices


Despite the government's push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices.

Aetna sees promise in oncology medical home


In a new oncology program in Florida, Aetna is trying to combine the medical home model with access to advanced care and translational research. Read more »

Rethinking managed care


What does managed care even mean these days? As the field has ballooned, its substance has been diluted, though it will still be useful in the new healthcare economy. Read more »

Cash-and-carry health insurance in Los Angeles


The largest publicly run health plan in the nation, L.A. Care, is letting customers who do not have traditional bank accounts to pay their health insurance premiums with cash. Read more »

Startup insurer Oscar gets $1.5 billion valuation


With another round of venture capital, Oscar Health Insurance is getting ready to enter new markets and try to become more than just a niche concierge health plan. Read more »

Of customers, beneficiaries, shareholder and taxpayers


Despite facing concerns about conflicts of interest, former UnitedHealth Group executive Andy Slavitt wants to blend the best of the private and public sectors in a bid to optimize the $1 trillion-plus health plans covering 140 million Americans. Read more »

Feds promise guidance for contraception EHB compliance


What constitutes reasonable limitations and management of contraception as an essential preventive health benefit? In the wake of new data and some consumer complaints, HHS may try to resolve gray areas. Read more »

UHG floats profitable quarter, sees busy year


Kicking off the spring season of managed care earnings statements, UnitedHealth Group shows that business is bustling for modernizing American healthcare and expanding insurance. Read more »

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