Fallon Health is departing from Massachusetts’ Medicare-Medicaid managed care program, another sign that the sought-after benefits and savings will be hard to achieve.
If the economics of running a health plan require the big to get bigger, it also seems that new models for services, risk and profits are needed.
With near-universal health insurance and an impetus to make healthcare affordable, health systems starting their own insurance plans believe this time is different.
Jay LaBine, MD, is a surgeon working at the forefront of America’s changing healthcare economy, the provider-sponsored health plan.
The trajectory of cancer care is so costly and problematic that insurers are flocking in droves to the federal government’s multi-payer alignment experiment.
Cigna is seeing benefits from its variety of accountable care in obstetrics and gynecology, and is on track to expand the model.
Unlike many local and state governments with steadily rising healthcare costs and a looming Cadillac tax, Houston is saving a fair amount with an accountable care network and wellness program.
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.
"We're comfortable being known as the health plan that wants to put health systems in the business of selling insurance."
Illinois' largest health insurer is building out its accountable care network, even as some of the health system partners are consolidating.
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.
In a new oncology program in Florida, Aetna is trying to combine the medical home model with access to advanced care and translational research.
Study finds doctors order fewer preventive services for Medicaid patients
Supreme Court's decision likely to impact health insurers as spouses join plans
Subsidies okay in federal marketplace, high court rules
Blues 'cartel' battle casts doubt on Anthem deal and more
Millennials want to work in health insurance?
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