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Covered California has big ideas for quality ratings


Covered California has unveiled health plan quality ratings to help guide insurance shoppers, ahead of most other states and the federal government. Read more »

WellPoint profits fall on contacts sale, but HIX sign-ups robust


WellPoint reported that fourth-quarter 2013 earnings fell nearly 68 percent on higher costs related to the sale of its contact lens business, but revenues rose on increased use of medical services towards the end of the year. Read more »

Judge orders St. Luke's Health to undo merger


A U.S. district court judge ruled in favor of the Federal Trade Commission in an antitrust case that may shape the future of hospital acquisitions of physician groups. Read more »

Struggling marketplace takes private HIX, brokers up on help offers


With Maryland Health Connection's website still dysfunctional, the exchange's board is turning to traditional and online brokers to salvage the public marketplace program. Read more »

First crop of Medicare ACOs navigate data problems


A survey of Medicare ACOs after their first year in operations suggests that all parties, government and private sector health organizations, have improvements to make in the coming years, especially when it comes to sharing data. Read more »

State pins hopes on telehealth to curb diabetes epidemic


Mississippi Gov. Phil Bryant is hoping to better control his state's diabetes epidemic with a new telehealth initiative, launching a public-private partnership to treat at-risk patients in underserved areas. Read more »

Blues start pregnancy medical home, see more ACO results


Horizon Blue Cross Blue Shield of New Jersey has launched the state's first patient-centered pregnancy and delivery episode of care program designed to bring about better outcomes, patient experience and lower costs through better coordination of care for pregnant women. Read more »

UnitedHealth may scoop up wellness startup


UnitedHealth Group may be acquiring another digital health company, this time eying the wellness market and an app already in use by thousands of members at a rival health plan. Read more »

Humana sued over consumer troubles cancelling policy


Humana is being sued by an individual policyholder claiming he has been unable to cancel the plan despite months of trying, in what may be first such lawsuit over insurance company practices during the transition to ACA-compliant health plans. Read more »

Please stop calling services 'free,' senators ask HHS


The Department of Health and Human Services is constantly promoting Medicare and the Affordable Care Act, but some Republican senators are getting annoyed with one slogan: "free preventive services." Read more »

Highmark's health system finds a partner for comprehensive oncology


Highmark's Allegheny Health Network is partnering with Johns Hopkins Medicine to offer members more options for cancer care in western Pennsylvania, while also bringing more competition to the region's dominant provider. Read more »

Amid reform clouds, ratings agency rethinks forecast for insurers


Continued uncertainty and regulatory surprises in the evolution of the Affordable Care Act have prompted Moody's to change its outlook of the health insurance industry for the worse, but not for every company. Read more »

Top 5 health policy issues facing states


Since a significant portion of states' health budgets go towards paying for Medicaid, public employees and public retirees, states are keenly aware of health policy and the need for innovation and reform to hold down costs while improving care. Read more »

Anthem among NQF quality, safety awardees


The National Quality Forum and The Joint Commission have announced the 2013 recipients of the annual John M. Eisenberg Patient Safety and Quality Awards. Read more »

Preventive Services Task Force mulling new colon cancer screenings


The U.S. Preventive Services Task Force is comparing the effectiveness of CT scans for colorectal cancer along with other alternatives to the standard colonoscopy, in the first step to getting Medicare and private insurers to cover new screenings for the nation’s second-leading cause of cancer death. Read more »

Part-time retail employees headed to public exchanges


Continuing a trend in the retail economy, Target is ending health insurance options for part-time employees and sending them to health insurance exchanges, following the likes of Home Depot and Walgreens. Read more »

HRAs giving way to HSAs


Health savings accounts are growing more than ever, and possibly eating into health reimbursement accounts for the first time since researchers have been tracking the plans. Read more »

Most employees happy with private HIX choices, some want more


Most employees who recently started buying their insurance through a private exchange report a fair amount of satisfaction with their choices, although whether that ends up saving employers and employees money still isn't clear. Read more »

Payers investing in consumer data platforms


As they try to get a better handle on population health management and member engagement, payers are increasingly looking to consumer-facing technologies for help, according to the latest report from Chilmark Research. Read more »

To close deficit, governor turns to hospitals, managed care


Hospitals and managed care organizations in Rhode Island are set to take reimbursement cuts under the governor's proposed budget — an untenable position, some say, as Medicaid expansion brings them more patients. Read more »

Surpassing projections, CT HIX now turns to diverse demographics


Connecticut's health insurance exchange is the first to meet its enrollment projections, but officials might be hoping to attract younger Nutmeggers before the 2014 open enrollment period ends. Read more »

UnitedHealth ends 2013 on the up, but girding for disruption


The first insurer to post last year's financial results, UnitedHealth Group saw revenues grow 11 percent but margins slip -- a sign of industry pressures ramping up in the new era of health reform. Read more »

States eye Novartis for Medicaid recovery in new lawsuit


After recovering claims from a pharmacy provider, a group of 27 states are suing Novartis, alleging the company participated in a kickback scheme to boost Medicaid sales for a controversial blood drug. Read more »

Top 10 issues roiling healthcare in 2014


Empowered consumers, rapid innovation and increasing competition are among PwC's top issues for providers and payers and other healthcare businesses for 2014, the company announced last week during a webinar. Read more »

HealthCare.gov tries to catch up with plan payments


Now that most consumer-facing parts of HealthCare.gov are working, the biggest problem is "making sure plans get paid," the lead manager of insurance exchanges and regulations at the Centers for Medicare & Medicaid Services told federal lawmakers. Read more »

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