One Medicare Advantage company offers a parable for what can go wrong in the business of managed healthcare.
Improving healthcare for the nation's Medicare-Medicaid dual eligible population seems to be just as complex as the beneficiaries' health needs, so state leaders are seeking help and more flexibility from the feds.
In a new market for western Pennsylvania healthcare lives, Highmark and UPMC are finding old disputes lurking, adding to consumer confusion amid a new product launch and open enrollment.
Another health system is taking a step into insurance with Medicare Advantage, banking on seniors wanting access to a prestigious brand.
Struggling Medicare Advantage and Part D drug plans are being given a last minute reprieve, although they will need to show more improvement if they want to stay alive longer than a year.
Health reform is creating a new impetus for regional payers and providers to collaborate on long-standing problems. Medicare is proving to be a good place to start.
Among providers trying to get into the insurance game, some are starting off small at the local level, but in a big, growing market segment.
Amid challenging trends in drug prices and formularies, independent pharmacy advocates are pushing for a new "any willing" provider mandate in Medicare Part D.
Federal health officials are increasingly scrutinizing Medicare Advantage risk adjustment, suggesting policy changes and even clawbacks to come.
Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.
Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.
Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive's spines.
The payer-provider collaboration impetus
Premera takes comprehensive telehealth strategy
Regence bets on 'accountable health' group plans
Vermont abandons single payer, for now
Medicare Advantage HMO dissolves amid fraud charges
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