Price matters for ACA exchange customers--but it isn't the only factor

Last year, 80 percent of consumers chose bronze or silver health insurance plans--the two lowest-cost tiers--but many did not select the cheapest plan within those tiers, according to a new report.


The business benefits of collaboration between insurers, patient groups

By working with groups that represent chronic disease patients, insurers can save money on costly therapies while ensuring patients have access to the treatments they need, according to a recent Health Affairs blog post.


Study: Uninsured rate has risen among young adults since 1970s

A new study that looks at data as far back as the mid-1970s shows that uninsured rates have actually increased among young adults--but the Affordable Care Act is making a dent i the numbers.

Opening arguments in ACA contraception case hint at deadlock

If Wednesday's opening arguments are any indication, the Supreme Court case regarding the Affordable Care Act's contraceptive coverage mandate could split the justices evenly, affirming previous rulings that the government exemptions offered to religiously affiliated organizations are lawful, but leaving other courts without a national precedent.


Blue Cross & Blue Shield of Rhode Island offers providers platform to harness data

In an effort to improve care quality and coordination, Blue Cross & Blue Shield of Rhode Island plans to arm primary care providers with the power of data.

GAO urges security, privacy controls for

The federal government must create procedures to oversee security of state-based health insurance marketplaces and continously monitor security controls for, the U.S. Government Accountability Office said in a recent report after finding "significant weaknesses" in technical controls. 


Payers and providers lose big with inefficient claims processing

Health insurers want error-free claims from providers and providers want accurate payment from payers--but both must improve processes to meet those goals.

CMS rejected plan to put Maine CO-OP into receivership

Though insurance regulators in Maine sought to put the state's struggling community operated and oriented plan into receivership to curtail its mounting losses, the Centers for Medicare & Medicaid Services rejected that plan, the Portland Press Herald reports

HHS: Affordable Care Act helped Medicare save $473 billion

As the Affordable Care Act turns six years old this week, the Obama administration is marking the occasion by highlighting its successes and laying out plans for how it might transform the healthcare system going forward.


Medicaid expansion saves states millions, boosts payer revenues

The 31 states and the District of Columbia that expanded their Medicaid program under the Affordable Care Act are saving millions, while revenues are up for both the states and its insurers, according to the Robert Wood Johnson Foundation.

AHIP launches initiative to improve accuracy of provider directories

A new pilot project announced by America's Health Insurance Plans aims to improve the accuracy of provider directories that have been plagued by imprecise information, leading to confusion among consumers seeking in-network care.


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.

Value-based payment model design pitfalls

To ensure that alternative payment models succeed, insurers and providers must avoid common missteps. 

Affordable Care Act, not economy, drives health insurance gains

Multiple reports indicate that the sizable increase in the number of Americans with healthcare coverage is mostly a result of the Affordable Care Act, rather than an uptick in the economy, according to the Associated Press.


Other states may hold answer to New Jersey's Omnia dilemma

As the controversy continues over Horizon Blue Cross Blue Shield of New Jersey's Omnia health plans, some say it's worth looking at other states to decide how to regulate tiered networks.

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.


Marilyn Tavenner sets aggressive goals for AHIP

AHIP CEO Marilynn Tavenner wants to bring UnitedHealth Group and Aetna back into the trade group's fold, close a $2 million budget deficit, fix the "antiquated fee-for-service methodology" used forMedicare Advantage and repeal the Cadillac tax--all in 2016.

A look at states' efforts to coordinate care for Medicare, Medicaid populations

Currently 13 states are working to align Medicare and Medicaid financing as well as integrate primary and acute care, behavioral health services and long-term services and supports through a variety of innovative methods, according to a new report from the Center for Healthcare Strategies.


How the two political parties approach healthcare risk pooling

When examining the health policies advocated by Democrats and Republicans—and their respective presidential candidates--it's clear that the two parties have two very different philosophies about how to pool risk in health insurance, according to a blog post from Health Affairs.

Connecticut touts success of its 'managed fee-for-service' Medicaid model

Connecticut's return to a more traditional "fee-for-service" arrangement in its Medicaid program--which runs counter to what many other states are doing--has enabled it to save money and improve care, according to an article from the Wall Street Journal.