Dori Zweig is an Associate Editor for FierceHealthPayer. Prior to joining Fierce, she worked at SAGE Publications as an Editorial Assistant. She’s held internships at various publications around Washington, D.C. - National Geographic and the Washingtonian magazine - and holds a BA in English from Gettysburg College. Dori lives in D.C., enjoys wandering the Mall when it’s tourist-free, Cherry Blossom season, running and reading. She can be reached at [email protected] or follow her on Twitter @HealthPayer.
Blue Cross Blue Shield of Michigan settled a lawsuit with Aetna, but must now resolve another with Health Alliance Plan of Michigan. Both lawsuits deal with charging agreements with various Michigan hospitals.
Public employees hired to create and build Healthcare.gov were not trained or managed properly to successfully complete their duties, according to a federal audit.
Under the Affordable Care Act, individuals who are 64 and older cannot be charged more than three times as much as 21- to 24-year-olds for the same plan. Many critics believe this 3-to-1 ratio discourages younger enrollees from purchasing plans and have thus proposed increasing the ratio to 5-to-1. But while 5-to-1 rate banding, as it's typically called, would insure more young people, federal health spending would increase and nearly 400,000 older people would lose coverage.
Democratic presidential candidate Bernie Sanders recently introduced legislation that would allow Medicare to negotiate prices with drug companies, which if enacted, could have major implications for both public and private payers.
The American Hospital Association and Association of American Medical Colleges submitted an amicus brief to the Supreme Court supporting Vermont's stance in the in the case of Gobeille v. Liberty Mutual Insurance.
From Affordable Care Act drama to industry consolidation, health insurance executives have had a rough few months.
As Medicaid accountable care organizations continue to gain traction, their success largely will depend upon states' ability to generate savings and overcome challenges. For the most part, states adopt ACOs for two reasons: To reign in cost-related concerns and to coordinate care across populations.
The lines between providers and payers are blurring as more and more providers enter the health insurance market--many with an eye on lucrative Medicare Advantage enrollees, says Avalere CEO Dan Mendelson in an interview with FierceHealthPayer.
Though there are growing concerns about narrow or preferred pharmacy networks, a CVS Health Research Institute study published in JAMA Internal Medicine finds that such networks actually improve members' medication adherence.
For the most part, consumer-driven health plans have a history of being more effective at reducing costs than traditional plans. Yet there also have been common misconceptions about CDHPs, according to a new white paper from Cigna.