What's next for healthcare marketplaces in U.S. territories?

The future of healthcare marketplaces in U.S. territories remains murky after the Department of Health and Human Services granted them exemptions last month to key provisions of the Affordable Care Act, California Healthline reported.

The balancing act between doctor reimbursement, premium costs

In the post-healthcare reform era, insurers face a new challenge--how can they pay doctors enough so they continue accepting their members while decreasing premiums to make them affordable for consumers? Insurers' attempts to shift some risk onto providers, through accountable care organizations, bundled payments and patient-centered medical homes, for example, cause administrative burdens for doctors, resulting in some denying care to patients with exchange plans, reported WNPR.

Are Medicaid insurers poised for takeovers?

As insurers continually point to providers' bargaining power as a primary driver of growing healthcare costs, many may be working to boost their own market strength by buying up smaller companies. Health analysts believe that Medicaid insurers, including Centene, Health Net, Molina and WellCare, are particularly poised for a merger or acquisition from larger insurers like Aetna, Cigna, Humana or UnitedHealthcare, reported Healthcare Payer News.

5 things to consider when planning ACOs

When insurers and providers create new accountable care organizations, there are certain considerations they should keep in mind to help guarantee the programs' success, according to a new blog post in Health Affairs.

To help insurers and providers implement critical features that often lead to successful ACOs, the Catalyst for Payment Reform and the Pacific Business Group on Health released a toolkit with some valuable lessons learned. We've rounded up several suggestions from the toolkit. 

Report: Premiums differ from urban, rural areas

People living in rural states have access to fewer insurance plans and higher premiums compared to consumers in the rest of the country, according to a new report from the University of Pennsylvania and the Robert Wood Johnson Foundation

'Healthcare sharing ministries' give faithful an alternative to Obamacare

More than 300,000 Americans bypass the Affordable Care Act's individual insurance mandate by buying limited healthcare coverage through faith-based collectives, the San Jose Mercury News reported.

Automatic enrollment proves controversial

The new health law provision that will automatically enroll individuals in a plan unless they opt out is proving to be controversial. Many businesses say the "default option" could cause confusion among employees who suddenly find themselves in a plan they didn't sign up for and might not want, reports Kaiser Health News.

3 ways insurers can head off confusion, 'rate shock' at next exchange open enrollment

With the 2015 health insurance exchange enrollment period comes a new round of potential problems that insurers should address before enrollment begins. To help prevent--or at least offset--members' price concerns and keep them from jumping ship, the authors shared several tips insurers can take before enrollment begins.

Earnings reports from insurers, hospitals send conflicting messages

The earnings reports from insurers and hospitals for the second quarter of this year have conflicting messages--hospitals are seeing a growth in volume while insurers are seeing a slower cost trend. Aetna, WellPoint and UnitedHealth all said costs are under control and the trends are moderate. And Cigna even lowered its cost outlook, believing the increase this year will be between 4.5 percent and 5.5 percent, reported Kaiser Health News.

Lower premium surcharges still prevent smokers from buying coverage

Although insurers are applying lower surcharges on members who smoke than what's allowed under the Affordable Care Act, tobacco users have still been less able than other consumers to afford health coverage, according to a new study published in Health Affairs.

Consumer-driven plans need more educational tools

If insurers want more people to sign up for consumer-driven health plans, they must provide specific tools and outreach to educate consumers and employers that provide these plans to their workers, reported Business Insurance.

Insurers work to improve health literacy

Healthcare talk is confusing enough for consumers who have a long history of coverage. It is even more so for the newly insured, which include the eight million Americans who purchased coverage during this past enrollment period. 

Medicare spending slowdown could put brakes on Medicare reform

Medicare spending will slow down over the next decade--and although this bodes well for the federal budget it could also slow down Medicare reform, notes a post in the Morning Consult.

Insurers expect consumer competition to soar in 2015

Some of the top names in the healthcare insurance industry expect a drive in competition among consumers in 2015, reports Forbes..

More medical groups turn to high deductible health plans for physician coverage

Medical groups, like hospitals and health systems, now take steps to reduce utilization and trim costs within their health insurance coverage options for physicians and families.

Go mobile to grab young adults' attention

All the kids are doing it these days, and WellPoint CEO Joseph Swedish knows it. What am I talking about? The constant use of smartphones. To capture young consumers' attention, Swedish is...

Kaiser Permanente's Jack Cochran on the path to value-based care

As a way of paying for quality rather than volume, many insurers are moving away from a fee-for-service payment model toward a value-based reimbursement process that focuses more on transparency and accountability, FierceHealthPayer previously reported. To better understand the benefits of a value-based payment model operates, spoke with California-based Kaiser Permanente's Jack Cochran (pictured), M.D., FACS,  executive director of the Permanente Federation in an exclusive interview.

Survey: Healthcare orgs taking a second look at historically generous employee health benefits

As healthcare costs continue to rise, hospitals and other healthcare organizations--which historically provide more generous employee benefits than in other industries--are scrutinizing the health insurance they offer their own employees, according to a new survey.

Poll: ACA popularity at all-time low

Fifty-three percent of Americans held unfavorable views of the Affordable Care Act in July, which is up eight percentage points from last month, according to the latest Kaiser Health Tracking Poll.

GAO report cites lack of planning, oversight for was developed without effective planning or oversight--and unless the Centers for Medicare & Medicaid Services takes steps to improve contract management and governance, upcoming open enrollment periods could face problems, according to a report released today by the Government Accountability Office. The report also highlights five recommendations for CMS.