Coordination of care to be reimbursable

Amid growing evidence that patients with chronic illnesses suffer from disjointed, fragmented care, the Obama administration is planning to pay doctors to coordinate the care of Medicare...

ACA legal challenges could cause trouble for states on federal exchange

A new analysis shows healthcare payers may face a rocky road as recent legal battles continue to brew over ACA subsidies.

Prescription drug tiers can't handle all budget woes, study shows

Over the years, insurers have tried--with varying degrees of success--to rein in prices and moderate the costs of prescription drugs. But to ensure consumers can afford speciality tier drugs, a new issue brief from the Robert Wood Johnson foundation recommends payers team up with state and federal regulators to combat the soaring prices.

Top 10 insurers in the Part D arena: UnitedHealth at the top

UnitedHealth is top dog when it comes to Medicare Part D presence in the U.S. health insurance market, according to a new study from the Kaiser Family Foundation.

Discrimination accusations plague insurers

Implementation of the Affordable Care Act was meant to stop insurers from discrimination against consumers with pre-existing or expensive-to-treat conditions. Yet many critics worry new barriers from healthcare insurers continually lead to certain bias, reports the Associated Press.

Blue Shield, Anthem of California bring health insurance into the 21st century

It's nice to see competitors working together for the good of the consumer. That's exactly what two of California's biggest insurers--Blue Shield of California and Anthem Blue Cross--did...

Top Blues execs in Alabama receive million-dollar pay increases

Top 10 executives at Blue Cross and Blue Shield of Alabama earned an additional $1 million each in 2013, and collectively have doubled their pay since 2011, according to an article on


Majority of voters continue to oppose ACA

For the past year, opposition to the Affordable Care Act--implemented back in 2010--has been above 50 percent. Once again, according to the latest Fox News poll, this continues to be true.

Pricey compounded drugs come under scrutiny

What does a $1,600 custom-made diaper rash treatment, $8,500 scar-reduction cream and a $2,300 pain-relieving salve all have in common? Their price tag, and more often than not, healthcare insurers are left to pick up the expensive bill for compounded medicines, reports the New York Times.

Challenges plague upcoming enrollment period

Despite providing coverage to more than 10 million previously uninsured Americans, the Affordable Care Act will face hurdles once November rolls around, reports the Huffington Post.

8 ways to standardize reimbursement

Without primary care physicians embracing the Affordable Care Act, transitions in American healthcare won't be easy. For starters, that would require payment alignment. 

Insurers, hospitals at odds over patient financial assistance programs

As healthcare costs rise, low-income consumers struggle to pay their premiums. So hospitals are finding ways to help individuals and families pay their share of subsidies. While this may bode well for the consumers in need, payers are not as thrilled with the initiative, reports Kaiser Health News.

Report: Young adults aren't invincible, they're 'cost-sensitive'

It's a stigma young adults tend to be unconcerned with health coverage and unaware of its benefits, but a new Deloitte report shows they're actually well-versed in health insurance--they just want a higher return on the money they spend for it.

Large employers using CDHPs, skinny plans to offset rising costs

Large employers expect health insurance costs to rise about 6.5 percent on average next year, so they're taking steps to reign in their spending, control costs and avoid taxes, finds a new survey from the National Business Group on Health.

Hospitals stand to lose $167B in non-Medicaid expansion states

Hospitals in the 24 states that didn't expand Medicaid will lose $167.8 billion in additional funding to offset cuts to Medicare and Medicaid reimbursement under healthcare reform, an analysis...

Satisfaction with consumer-driven health plans on the rise

The overall satisfaction rate among consumer-driven health plan enrollees is on the rise, but on the way down among those in traditional managed care plans, according to the latest research from the Employee Benefit Research Institute.

WellPoint changing name to Anthem to create unified brand

WellPoint Inc., the second-largest health insurer in the U.S., which operates Anthem and Empire Blue Cross Blue Shield plans, announced yesterday that it's changing its name to Anthem, Inc. to better align its corporate identity and product brands, the Wall Street Journal reported.

Report: Higher premiums found in less competitive markets

The less competitive a health insurance market is, the higher the premium rates are, according to a report funded by the Robert Wood Johnson Foundation.

IBC puts docs at center of care transformation

Independence Blue Cross is putting doctors front and center of its initiative to reduce costs and improve patient health, WHYY reported. It has recruited almost 300 primary care doctors to join its...