Third Party Administrators

November 10, 2015 | Kaiser Health News

Though healthcare systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging.

October 12, 2015 | Susan Morse

Horizon Blue Cross Blue Shield of New Jersey's new ONMIA health alliance is under scrutiny from legislators in the state who want to delay the plan's rollout amid questions of how hospitals were chosen for the Tier 1 network.

September 11, 2015 | Susan Morse

As a Standard & Poor's report finds many insurers are missing the mark on their risk-adjustment predictions, a new partnership between population health management consultant Evolent Health and Health Fidelity, which develops technology to steer providers towards value-based care, aims to fill the gap.

September 8, 2015 | Kaiser Health News

California legislators passed a bill postponing a controversial plan that would have shifted tens of thousands of medically fragile children into Medi-Cal managed care plans.

September 8, 2015 | Susan Morse

Managed care company Molina Healthcare said it will pay $200 million for the remaining stakes in two subsidiaries of The Providence Service Corp.

September 1, 2015 | Henry Powderly

While hospital merger and acquisition deals in the second quarter of 2015 slid when it came to volume, the total dollar amount of the deals jumped on a few major takeovers, according to new research by PricewaterhouseCoopers.

May 13, 2015 | Jay Hancock, Kaiser Health News

In the late 1990s you could have taken what hospitals charged for inpatient chemotherapy and bought a Ford Escort econobox. Today average chemo charges are enough to pay for a Lexus GX SUV, not even counting the price of anti-cancer drugs.

May 6, 2015 | Anthony Brino

As long as employer-sponsored benefits are here to stay, one technology company wants to be a modern kind of broker and HR service. It may or may not spell an early retirement wave for a generation of insurance producers.

March 24, 2015 | Anthony Brino

Silicon Valley is coming for the employer sponsored health insurance business, trying to raise the bar on group health benefits and "democratize" self-funding.

February 27, 2015 | Anthony Brino

The Internal Revenue has released temporary regulations and proposals for the health "9010" insurance fees required by the Affordable Care Act.

February 18, 2015 | Anthony Brino

Once again, insurance practices on cost-sharing and reimbursement for out-of-network providers and PPOs are ending up in dispute, with backlash from providers and customers.

February 11, 2015 | Anthony Brino

In the wake of Anthem's massive data breach, a storm of class action lawsuits are raising concerns about information protection, liability and regulation.

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