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The recent performance-based deal that Novartis cut with two insurance giants could signal the beginnings of a new approach to drug pricing, according to a Bloomberg editorial.
If the "big five" U.S. health insurers' fourth-quarter earnings reports made one fact clear, it's that the profitability of their Affordable Care Act exchange products continues to be an issue.
Though the concept of designing cancer care "pathways" has potential, oncologists have reason to be concerned about the possibility of health insurers determining these pathways on their own, according to an opinion piece published in JAMA Oncology.
Seeking to stem their financial losses on Affordable Care Act exchange products, health insurers have started to discourage consumers from signing up for coverage outside of standard enrollment periods and choosing less-profitable plans, Kaiser Health News reports.
Aetna on Monday reported a net income of $320.8 million, or $.91 per share, in the fourth quarter of 2015, a 38 percent rise from the same time last year.
Nearly 60 percent of new entrants to the Medicare Advantage market are provider-sponsored health plans, according to a new report from Avalere Health.
As lawsuits involving out-of-network billing continue at a brisk pace, health insurers should know how the courts have ruled in some key, publicly published cases in order to guide their business practices, writes Luke Punnakanta, of the firm Manatt Phelps & Phillips LLP, in an article for Lexology.
The industry's largest trade association hopes to convince the two major health insurers that left its ranks to return amid a particularly high-stakes year for payers.
In the wake of Aetna's announcement that it would leave America's Health Insurance Plans, speculation has continued to swirl about what it means for the industry. Some think two insurers' decision to part ways with AHIP may herald a new chapter in which multiple trade associations and interest groups represent the insurance industry.
Among the slew of criticisms highlighted in recent comment letters about proposed Affordable Care Act marketplace reforms, one major theme emerges--insurers are very concerned about consumers' use of special enrollment periods.
Press Releases
- AHIMA Launches Petition for National Voluntary Patient Safety Identifier
- HHS announces major commitments from healthcare industry to make electronic health records work better for patients and providers
- Statement by Theranos on CMS Audit Results
- MISSING PIECES: MAJOR HEALTH DATABASE HAS DEEP FLAWS
- Majority of Americans Don't Use Digital Technology to Access their Doctors
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