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In crowded HIX, co-op nabs market share and solvency concerns


Another cooperative insurer is boasting about low premiums attracting droves of new exchange members, raising questions about long-term viability in the wake of CoOportunity's liquidation. Read more »

Highmark turns to at-home tests in prevention effort


Highmark is expanding a low-cost approach to colon cancer screening that could help increase early detection while also avoiding the discomfort of invasive scoping and high treatment costs. Read more »

State regulators hold Excellus, others to new mental health standards


Insurers in New York are agreeing to reform their policies for behavioral healthcare treatment and rehabilitation coverage, after an "unprecedented enforcement effort of mental health parity laws." Read more »

Hacking the Blues, again


It's turning out to be a problematic year for health insurance IT management. Another Blue Cross insurer company has been hacked, and this time it seems that subscriber medical information was exposed. Read more »

Could Blue Shield of California become a tax-paying for-profit?


Facing scrutiny over executive compensation, reserves and premiums, California's third largest insurer is under pressure to justify its state tax exemption, and state finance authorities wants to start collecting. Read more »

Health plan customer experience as bad as cable?


In a new customer experience survey, health insurers are just above the bottom, perhaps in part because the nature of the service and the industry's legacy. But some still came ahead with positive reviews. Read more »

ACA chips away at uninsured, 16M covered


A total of 16.4 million non-elderly adults have gained health insurance coverage since the Affordable Care Act became law five years ago this month, a "historic" reduction in the number of uninsured. Read more »

UHG could lead new controls on hysterectomies


The nation's largest insurer may be setting a precedent with restrictions on a risky, though recently popular approach to the most common gynecological surgical procedure. Read more »

Health plan apps: Serving multilingual consumers


Following the nation's changing demographics at the local level in some major markets, Humana is making a small investment in more convenient service for Hispanic and Latino members. Read more »

States phasing out grandmothered plans


Some state health insurance markets are in for another exodus of pre-health reform plans, as regulators pursue stability on and off the public exchanges. Read more »

Cambia sounds clarion call for entrepreneurism, sustainability


Despite a proliferation of digital health companies, payers, providers and patients have many unmet needs. The Pacific Northwest's oldest insurer is trying to help find new ideas, outside the industry. Read more »

Massachusetts Blues try to go all in for FFS alternative


With two-thirds of Massachusetts healthcare still paid via fee-for-service, the state's largest insurer wants to ply its HMO-grown variety of accountable care in PPOs. It's sure to challenge providers. Read more »

Consumers getting more credit flexibility on medical debt


Too many consumers have learned the hard way that their credit rating can be tarnished by medical bills they may not owe or when disputes delay insurer payment. Read more »

Layoffs, losses at eHealth


The company that defined health insurance e-commerce is struggling in the new market, despite an attempt to sell subsidized health plans, and is now looking to Medicare. Read more »

Push for pregnancy as qualifying event raises incentives questions


The Department of Health and Human Services is being urged to add another qualifying event to the list of ways people can buy an exchange plan in a "special enrollment period." Read more »

New drugs, pharma biz models driving $500B spending wave


Health insurers and American consumers might be spending more than ever for prescription drugs, but there are also more choices and more information to find value in a sea of volume. Read more »

Capital Blue Cross brings in ACO benefits


Pennsylvania's smaller Blue-licensed insurer is boasting of some notable results in its accountable care arrangements and is looking to bring similar contracts to small primary care practices. Read more »

Marketplace that never was, Cover Oregon closes


After $300 million, thousands of hours of labor and a few lost government careers, one of the biggest disappointments in progressive health policy has reached the end of the road. Read more »

Anthem refuses full security audits, feds say


The nation's second largest insurer is taking some flak for declining a second opinion on its information technology security. Read more »

HIX, MA plans must update directories


Starting next year, health insurers have to give Americans in Medicare Advantage plans and federal exchange policies up-to-date details about which doctors are in their plans and taking new patients. Read more »

CMS seeks to tame 'outliers' in preferred Medicare drug plans


An increasingly popular strategy in drug plan affordability is again coming under scrutiny from Medicare regulators concerned that some urban seniors are being left out. Read more »

First biosimilar approval may not guarantee new options


Health insurers and patients could get a bit of relief after years of paying more and more for biologic speciality pharmaceuticals, but some think there are still barriers to affordability. Read more »

In another integration attempt, Sutter Health grows an HMO


One of the Bay Area's most popular health systems is expanding its new health plan, trying to craft a unique value proposition in changing times and picking up some notable clients along the way.  Read more »

HCSC shuffles executive leaders to and from BCBSIL


The nation's fourth largest insurer is calling on the leader of its flagship plan to manage technology and services across its regions, while ushering in a new president at the 7 million member company. Read more »

Healthy one percent margin for Michigan Blues in new market


After transitioning from tax-exempt nonprofit to a tax-paying, mutually-owned company, Michigan's largest health insurer is in pretty good financial health. Read more »

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