In Virginia, the debate regarding Medicaid expansion continues, reports the Associated Press. If the state decides to expand Medicaid to about 400,000 low-income residents, those eligible will have private insurance paid for with federal funds.
Health insurers are worried about keeping up with regulatory changes and maintaining compliance. But these challenges present significant opportunities for insurers' CIOs to improve operations with open architecture and real-time views, Healthcare Payer News reported.
Now more than ever insurers are monitoring their diabetic patients to ensure they don't miss appointments or forget to fill up prescriptions, reports the Associated Press.
The growing population health movement has led insurers and providers to patient-centered medical homes (PCMH), accountable care organizations and other integrated care models to improve the outcomes and reduce the costs for patient populations.
The cost of specialty medications is expected to rise to $235 billion by 2018, providing many cost-related challenges to payers. To off-set these costs, health insurers can move prescription benefits from medical to pharmacy coverage, according to a new Milliman report commissioned by CVS Caremark.
Insurers selling exchange plans that try to boost young adult enrollment by discriminating against consumers with significant health needs or disabilities should be wary of compliance reviews, according to new qualified health plan guidance from the Centers for Medicare and Medicaid Services.
Kathleen Sebelius--the public face of the botched HealthCare.gov rollout-- is stepping down from her post as secretary of the U.S. Department of Health & Human Services, according to multiple news outlets.
As the self-insurance market continues to rise, commercial full-risk insurance declines. Commercial full-risk enrollment fell from 80.5 million in 2011 to 78.5 million in 2012--a 2.5 percent drop, according to findings from Citi Research.
A rising number of Texas primary care practitioners are switching to a cash-based model to avoid the bureaucracy of the health insurance system and high processing costs, The Texas Tribune reported.
Kathleen Sebelius is expected to announce that she is stepping down from her post as Secretary of the U.S. Department of Health & Human Services on Friday, according to multiple news outlets.
The effects of expanded private coverage and Medicaid under the Affordable Care Act go beyond health insurers to other liability insurance companies, namely, auto insurers, a new report from the Rand Corporation finds.
The percentage of children without insurance fell from 9.7 percent in 2008 to 7.5 percent in 2012, largely due to public programs like Medicaid and the Children's Health Insurance Program, according to a new report from the Robert Wood Johnson Foundation.
Some insurers still expect to see Medicare Advantage rates drop next year, even though the Centers for Medicare & Medicaid Services reversed course on proposed rate cuts earlier this week.
The United States has about 3 million new Medicaid enrollees, but hundreds of thousands of those consumers are still unable to obtain coverage, ProPublica reported.
We now know the uninsured rate has reached a record low thanks to the Affordable Care Act, but it remains unclear whether the millions of newly insured people will actually become healthier and, therefore, reduce overall costs, reported The Health Care Blog.
If the United States implemented a single-payer health insurance system, small and large businesses would reap the benefits, including seeing their costs go down, according to a new report from Public Citizen.
Limited data does not prevent payers from covering high-risk devices, concluded a new study commissioned by The Pew Charitable Trusts.
New enrollees who purchased coverage through state and federal marketplaces are more likely to use specialty medications, such as those used to treat HIV/AIDs and hepatitis C, than people enrolled in commercial health plans, Express Scripts research finds.
WellPoint and other California insurers have donated $13.4 million toward defeating a ballot initiative that would authorize California regulators to reject increases in premiums, Bloomberg reported.