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UHG dives into convenient care space


Just as rival Humana exits the market, UnitedHealth Group is growing its portfolio of retail health clinics, in another step towards insurer-owned healthcare delivery. Read more »

More mental health parity coming for Medicaid, CHIP


A 2008 federal law was supposed to ensure that when patients had insurance benefits for mental health and addiction treatment, the coverage was on par with what they received for medical and surgical care. But until now, the government had only spelled out how the law applied to commercial plans. Read more »

Spring song for Medicare Advantage


For the third year, regulators have revamped reimbursement reductions into an average increase for Medicare plans serving America's growing senior populations, though not without requiring more work and oversight. Read more »

In executive moves, Horizon turns to analytics


Horizon Blue Cross Blue Shield of New Jersey is on the trail of all things data, with a new executive position given a charge of making sense of it all, plus some other major comings and goings. Read more »

Large firms take workers shopping for spine surgery


The likes of Lowe's and Walmart are moving ahead with the providers of excellence bundled payment model, applying it to a costly surgical treatment that's being marketed to an aging workforce with a low back pain epidemic. Read more »

Seattle provider plunges into price transparency


One health system is getting on the wave of health transparency and posting price estimates, although it still comes with barriers to patients shopping around for health services. Read more »

Mental health advocates call out roadblocks in parity journey


A lot of health insurers still have many miles to go on the road to parity for consumers seeking mental health and substance abuse treatment, patient advocates maintain. Read more »

Massachusetts offers a warning about universal coverage and hospitalizations


New evidence from Massachusetts suggests that expanded health insurance may not bring the needed benefits of reduced hospitalization, and could spur a rethinking of cost-sharing for valuable primary care. Read more »

California docs push for choice in how they die


As the palliative care movement grows, more and more physicians feel that so much effort is spend trying to extend life that few focus on what patients want in their last days. Read more »

Americans not really crazy about health accounts


Even though consumers are digging deeper to cover rising out-of-pocket medical costs, they're contributing less to health savings accounts that could help take the sting out of their expenses. Read more »

Fraud watch: Free sneaks for Medicaid cards


The perpetrators of an alleged Medicaid and Medicare fraud involving complimentary shoes and fake diagnoses could face 25 years in prison, as investigators across the country try to prevent or at least find fraud schemes that never seem to end. Read more »

Highmark posts stable finances in beginning of long game


Pennsylvania's largest insurer and newest integrated delivery network operator took a financial loss for the second year in a row, but that may actually help if scrutiny of its nonprofit status continues. Read more »

In Medicaid, Anthem sees massive chance to redesign healthcare


Can Anthem, the insurance giant famous for the for-profit Blues, "reconceive Medicaid as a care-delivery model rather than as an insurance program"? Read more »

Study: HIX plans miss compliance with smoking cessation


Are exchange insurers failing to adequately cover mandated tobacco cessation at no cost-sharing, or just not explicitly highlighting the benefits? Read more »

Illinois co-op boasts of turnout in enrollment tourney


Across the Mississippi River from a bankrupt cousin, a Midwestern cooperative insurer is entering year two with a sizable membership that will test its model of partnering with hospitals. Read more »

Garden State insurers fight to change out-of-network charge regs


Health insurers in New Jersey are complaining of a cost crisis arising from regulations meant to protect patients receiving emergency healthcare and involuntary out-of-network treatment. Read more »

UHG invests $12B to create giant drug manager


America's largest insurer is looking for all the scale it can get in the war for affordable medicines. Read more »

For private exchanges, many miles to go


There is a fair amount of hope for private health insurance exchanges in the commercial group market, but a pure defined contribution option will actually require a quite disruptive change. Read more »

How health reform went south in Mississippi


After the Affordable Care Act, Mississippi became the only state in the union where the percentage of uninsured residents has gone up, not down. Read more »

Employer wellness programs spend record $693 per worker


American employers are spending more on wellness programs than ever, but also backing away from penalties, as consumers respond with skepticism and researchers keep probing ROI evidence. Read more »

Cigna, SCAN team up for MA-EGWP market


Cigna is looking for business in younger, yet-to-retire baby boomers in California, anticipating the benefits of streamlining the path from group health plan to Medicare Advantage. Read more »

Could the health insurance tax be repealed?


Amid a possible bipartisan break in the clouds of Congress, insurance advocates see a window for changing or even repealing the much-loathed health insurance tax in the Affordable Care Act. Read more »

Medical devices desperate for more transparency, Aetna warns


Staring down the sometimes troubled and opaque past of medical devices, and upward trend in spending, one national insurer is trying to build momentum for a universal way to compare and track outcomes. Read more »

Tax tribulations: ACA complicates filing for many


This tax season, for the first time since the health law passed five years ago, consumers are facing its financial consequences. The worst may be yet to come. Read more »

Problems, potential of self-funding draw would-be disruptors


Silicon Valley is coming for the employer sponsored health insurance business, trying to raise the bar on group health benefits and "democratize" self-funding. Read more »

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