Latest Headlines

Latest Headlines

Express Scripts CEO wants to resolve dispute with Anthem

The incoming CEO for Express Scripts wants to resolve a longstanding drug pricing dispute with its largest client that has morphed into a lawsuit, a confrontation that underscores the growing negotiating power for large insurers and questions Express Scripts' independent business model.

Anthem sues Express Scripts over drug prices

Anthem's public spat with Express Scripts has escalated into a lawsuit against the pharmacy benefits management company charging it with failing to pass on prescription drug savings.  

Health Care Service Corp., Anthem cut commissions for individual plans

Following in the footsteps of some of the country's largest payers, several Blue Cross and Blue Shield (BCBS) insurers have said they will cut back on sales commissions for Affordable Care Act policies, according to a  Forbes  post.

HIMSS16: Tackling the impossible task of cybersecurity

While attendees at this year's Healthcare Information and Management Systems Society conference in Las Vegas no doubt will be interested in hearing about how providers, payers and innovative...

Express Scripts disputes Anthem's claim that it's owed $3B

While Anthem's pharmacy benefit manager, Express Scripts, says it is "fully committed to good faith negotiations" with the insurer amid a contract dispute between the two companies, its CEO questioned Anthem's claim of significant owed savings.  

Q4 earnings roundup: Big five insurers' ACA exchange woes deepen

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.

Docs say oncologists--not payers--should determine cancer care pathways

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.  

Insurers move to stem ACA losses--but at expense of consumers?

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.  

How payers, drug companies can partner to further value-based payments

While they sometimes have opposing interests, payers and drug companies can work together so that patients have better access to new, innovative medications, according to a  Health Affairs Blog  post.

Telemedicine: How providers, payers are progressing amid continued hurdles [Special Report]

In this special report, John Jesser, vice president of provider engagement strategy for Anthem's LiveHealth Online service, and Judd Hollander, associate dean for strategic health initiatives at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, discuss how each of their organizations is working to improve care access for patients via telemedicine, the hurdles they currently face and their thoughts on the state of the industry at large. Special Report