Latest Headlines

Latest Headlines

Critics push back against new Medicare Part B payment proposals

When the Obama administration announced its plan to test new ways of paying for prescription drugs under Medicare Part B, a slew of criticism from industry stakeholders quickly followed--though some say they see potential in the new models.  

Aetna merges iTriage with WellMatch

Aetna has merged its health app-maker subsidiary, iTriage, with its cost transparency business, WellMatch, to form one group, according to  MobiHealthNews.

Horizon's Omnia sparks debate about health plan transparency

In a hearing Monday on the topic of transparency in tiered health insurance plans--such as Horizon Blue Cross Blue Shield's Omnia--New Jersey legislators to tackled the daunting task of determining how much insurers should have to disclose when creating new products, according to the  American Journal of Managed Care.

What the Gobeille v. Liberty Mutual ruling means for healthcare transparency

Tuesday's Supreme Court ruling in the  Gobeille vs. Liberty Mutual Insurance Co.  case goes beyond the rules surrounding states' authority to require self-funded plans to submit claims information, as it has major implications for the future of healthcare transparency, according to an article from  ProPublica.  

New Jersey's Omnia network continues to take heat on tiering process

Horizon Blue Cross Blue Shield of New Jersey's tiered provider network, Omnia, has come under heavy criticism over accusations of shutting out major Garden State hospitals. A column in the Newark...

Medicare grants for-profit company full access to claims database

Medicare will provide complete data at the national level to a San Francisco-based for-profit start-up company with the goal of providing the most accurate physician information to patients so they can make the best decisions for their healthcare needs, according to an article from  U.S. News & World Report.  

Report cards make consumers' opinions about insurers public

The five insurers operating Medicaid managed care plans in Ohio only scored an "average" rating when it came to how satisfied their members were with their doctors, according to a new report card from the state.

Balance is key when establishing a narrow network

While narrow provider networks may lower premiums, they have the potential to limit access to care and increase out-of-pocket costs. So it's still uncertain if narrow network plans can work under the Affordable Care Act,  according to a new policy brief from the Urban Institute.

EOBs don't help consumers understand coverage

A majority of insurers' explanation of benefits statements don't help consumers understand what their plan covers for specific claims, says a new report from consultants Dalbar.

New health plan accreditation rules would scrutinize narrow networks

The National Committee for Quality Assurance wants to overhaul its health plan accreditation program to better align with market and stakeholders needs. With that in mind, the proposed changes focus on provider networks and transparency.