Push intensifies to stop ACA from expanding small-group market

Now that Congress is back in session, the effort to alter Affordable Care Act provision that would expand the definition of the small-group insurance market has begun to gain momentum. 

Wellness programs: Skip the bad press by using a softer touch

Wellness programs seem to be drawing nearly as much flak as praise these days. A report last week from Kaiser Health News indicated that many employers are raising the bar when it comes to what they...

Report: Raising Medicaid eligibility age would be costly for states

Raising the Medicare eligibility age from 65 would come with a hefty price for states, according to a report from the Urban Institute, produced with funding from The SCAN Foundation.

Startup Clover Health bets that improved use of data will equal better care

Make way for yet another startup in the health insurance space--this time, it's a company that wants to harness claims data to improve clinical outcomes for older patients.

Ruling could trigger new Supreme Court review of contraceptive mandate

The Affordable Care Act may be heading back to the Supreme Court. A U.S. Court of Appeals in the 8th Circuit in St. Louis, Missouri, ruled this week that the ACA unlawfully burdens religiously affiliated employers by forcing them to help cover the costs for certain contraceptives despite being able to opt out of paying for them.

What went wrong with Iowa's Medicaid expansion

Iowa's plan to expand the state's Medicaid program has not gone smoothly. And now, state officials plan to scrap the program all together. 


Healthagen exec: Aetna-Humana merger boosts transition to value-based care [Q&A]

How will Aetna's ACO and population health strategies mesh with Humana, which through its booming Medicare Advantage business has also been a major player in value-based payment models? To find out, FierceHealthPayer spoke to Charles Kennedy, chief population health officer for Aetna's provider solutions business, Healthagen.

Cigna CEO Cordani: Mergers will increase choice, not decrease affordability

In light of Anthem's deal to acquire Cigna, as well as Aetna's planned acquisition of Humana, Cigna CEO David Cordani is sticking up for the recent consolidation through the industry.

Montana's plan to put private firm in charge of Medicaid expansion likely to be pricey

Now that is has unveiled its plan to expand Medicaid, Montana must decide on a private firm to manage the program--and the cost is likely to be high.

Impact of proposed rule on transgender care unclear for payers

The Obama administration recently proposed a rule that would strengthen protections against gender-identity discrimination. But it's not clear how it will impact the health insurance industry.

GAO slams oversight of state insurance marketplace IT spending

The federal government has fallen short in tracking spending on state health insurance marketplaces, dividing responsibility across multiple offices and creating confusion in the process, according to a report from the Government Accountability Office.

As uninsured rate dips, so do ethnic coverage disparities

Amid news that the overall rate of uninsured Americans has declined, a study also highlights the progress the country has made in closing coverage gaps between minority groups and white adults.

Medicaid expansion tied to drop in uninsured hospital discharges

Before implementation of the Affordable Care Act, the number of Medicaid and uninsured hospital discharges in states that both expanded and did not expand Medicaid changed in a similar pattern each quarter. But beginning in 2014, new trends indicate that coverage expansion may lead to decreases in uncompensated care for the uninsured.

Could insurer mergers lead to a single-payer system?

Since four of the country's major health insurers announced their plans to pair off, the primary industry reaction has been characterized by scrutiny and skepticism. But Art Caplan, founding director of the Division of Medical Ethics in NYU Langone Medical Center's Department of Population Health, is the rare exception to this rule, writing in an opinion piece for The Health Care Blog that stopping these deals is a "terrible idea."

Doubts surround effectiveness of wellness plans aimed at weight loss

As American companies continue to expand wellness programs for their employees, one former Harvard professor says the whole concept is suspect at best, according to BenefitsPro.

Feds solidify position on employees' max out-of-pocket healthcare costs

Federal regulators have reiterated the maximum out-of-pocket amount employers can require employees to pay before their healthcare coverage begins: $6,850 for single coverage and $13,700 for family coverage. 

Aetna's plan to disrupt the healthcare industry

Before Aetna gained national attention with its plan to merge with fellow health insurer Humana, CEO Mark Bertolini has been hard at work trying to disrupt what he sees as a broken healthcare system, according to a strategy+business blog post.  


Google Capital invests $32.5M in Oscar

Google Capital has invested $32.5 million in Oscar, the startup health insurance company's CEO Mario Schlosser tells the Wall Street Journal. Now, Oscar is valued at $1.75 billion, up from $1.5 billion as of April.

Eliminating ACA's individual mandate would reduce deficit by $300B

Repealing an Affordable Care Act requirement that most Americans obtain minimum essential health insurance or pay a tax penalty would save an estimated $300 billion over the next decade, according to new federal estimates from the Congressional Budget Office. 

Senator wants Congress to act on cybersecurity in wake of Excellus breach

The latest healthcare data breach, which involved a massive hack of Excellus Blue Cross Blue Shield, has a U.S. senator calling for action on a cybersecurity bill that has been stalled in Congress.