3 reasons insurers will likely request higher rates in 2016

Expect health plans to request higher rates in 2016. That was the message Kim Holland, director for state affairs with the Blue Cross and Blue Shield Association, delivered at a conference on Affordable Care Act insurance exchanges.

California decision to end Blue Shield's tax exempt status faces questions

One advocacy group believes that state officials may have wrongly taken away Blue Shield of California's tax-exempt status as a nonprofit, so it's demanding to see public records related to the decision.

Health Insurance Providers Fee hurting states

A loophole in the Affordable Care Act's Health Insurers Providers Fee appears to benefit payers at the expense of state governments.

Success of Medicaid expansion cause for celebration, concern

The battle over Medicaid expansion continues. While supporters of the program are thrilled with the enrollment figures, opponents fear the rising costs will plague states. 

Low enrollment, technical issues hit state exchange budgets

The financial challenges facing state health insurance exchanges are no secret--and a recent Commonwealth Fund report spells out the struggles each state faces in its efforts to achieve financial sustainability.

Aetna eyes Humana's value-based care potential

The health insurance industry's latest overhaul to shift away from paying for volume to paying for value may be behind Aetna's rumored deal to acquire either Cigna or Humana. 

What to expect from the Medicaid managed care proposal

The federal government will soon propose new regulations to Medicaid managed care rules for the first time since 2002. The Centers for Medicare & Medicaid Services--which has been working on updating the regulations for more than a year--plans to address beneficiary information, provider network requirements and how plans spend money they receive from the program.

High deductibles main reason Americans go without medical care

One in four adults with non-group healthcare coverage did not receive needed care because it cost too much, according to a new report from nonprofit Families USA.

ACA premiums higher in areas without PPOs

Premiums for Affordable Care Act insurance plans are higher in counties that lack preferred provider organizations (PPOs), according to a HealthPocket analysis of premiums for plans sold on

Top seven insurers added 5.6 million members in 2014

The 2014 plan year was a good one for the nation's seven largest insurers, who collectively added 5.6 million members and generally saw profit margins in excess of 3.5 percent.

Not expanding Medicaid, losing federal subsidies would hurt states

An estimated 9.8 million Americans may be uninsured come 2016 should states continue to forgo Medicaid expansion and should the Supreme Court side with the plaintiffs in King v. Burwell and determine federal subsidies are illegal in states not operating their own health insurance exchanges, according to a new issue brief from the Robert Wood Johnson Foundation.  

Nearly all companies plan to stick with employer-sponsored health plans

Nearly all employers who now offer insurance to full-time workers will continue to do so in 2016, though the likelihood of offering covering five years from now dips slightly.

Payers can curb smoking-related costs by making members pay

Insurers may want to consider penalizing  members who don't quit smoking as an incentive to motivate them into changing the expensive behavior that costs insurers billions of dollars in healthcare coverage.

A healthcare funding story only fit for Florida

Spend enough time on the Internet and you eventually come across a meme called Florida Man. The term typically describes an oddball criminal committing the sort of misdeed that, for whatever reason,...

IRS raises health savings account limits for 2016

The Internal Revenue Service raised the maximum allowable contribution to a health savings account by $100 for 2016. 

Report: Medical loss ratio helps insurers

Prior to 2011, there was no rule that required insurers to provide enrollees with a specified minimum value in health spending in return for each dollar spent on premiums. However, thanks to the medical loss ratio mandate, insurers began using a much higher percentage of premiums on actual health spending, according to a new  Robert Wood Johnson Foundation report.

How to prepare state exchanges for long-term growth

Better investments in consumer-facing technology will help state exchanges attract customers and increase the likelihood of sustainability.

Humana's stock prices could thwart Aetna deal

Amid speculation this week that Aetna may make an offer to acquire either Humana or Cigna, industry analysts note a variety of factors that must take place for such a deal to occur.  

New payer guidelines on preventive mammogram screenings could affect 17M women

Health insurers won't have to pay for biennial mammograms for female members until they're 50 years old if an independent panel of medical experts moves forward with its new breast cancer screening guidelines.

Report: Seniors want independence following treatment

Seventy-six percent of Americans aged 65 and older believe independence is the most important health outcome following treatment,  according to a recent report from the Alliance of Community Health Plans.