March 3, 2015 | Anthony Brino

One of the largest Blue Cross insurers in the American South has taken its first loss in 15 years, showing the challenges of the two main growth areas, ACA plans and Medicare Advantage.

February 23, 2015 | Sarah Varney

In the farming town of Exeter, deep in California's Central Valley, Anne Roberson walks a quarter mile each day to her mailbox. Her walk and housekeeping chores are the 68-year-old's only exercise, and her weight has remained stubbornly over 200 pounds for some time.

February 20, 2015 | Anthony Brino

Medicare Advantage reimbursement and regulatory changes are coming, along with new probes into risk adjustment practices that could lead to settlements and clawbacks.

February 6, 2015 | Anthony Brino

Despite some membership losses, the country's fourth largest Blue Cross insurer is boasting fairly strong customer retention as a sign of viability for its integrated network strategy.

February 4, 2015 | Anthony Brino

With the surging costs of specialty drugs, what was once unthinkable in American healthcare is starting to look like a viable idea that the President is pushing.

February 3, 2015 | Anthony Brino

Aetna is positioning itself to ride out the early storms of health reform and end up plying the new waters sustainably.

January 28, 2015 | Anthony Brino

Humana and DaVita are joining forces to try out a new way to serve high risk, special needs patients with a primary care-led model.

January 27, 2015 | Anthony Brino and Susan Morse

The U.S. Department of Health and Human Services wants have 50 percent of Medicare reimbursements tied to quality and value by 2018, even if that includes fee-for-service.

January 22, 2015 | Anthony Brino

In a crowded market dominated by the Blues, a hospital-owned health plan is trying grow in tandem with Medicare and Medicaid enrollment, seeing potential in suburban Baby Boomers.

December 18, 2014 | Anthony Brino

One Medicare Advantage company offers a parable for what can go wrong in the business of managed healthcare.

December 4, 2014 | Anthony Brino

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.

October 8, 2014 | Anthony Brino

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.

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