Experimentation is the name of the game in a vastly complex healthcare industry. Insurers toy with new, innovative payment methods constantly, and all have a similar goal in mind: improve the quality of care while also lowering costs.
Health advocates in Texas are helping the state's minority population overcome language barriers, technical issues and low awareness of who is eligible to obtain health coverage under the Affordable Care Act.
As the healthcare landscape continues to evolve and transform the approach to managing patient care, new innovations, such as accountable care organizations (ACO), are success stories.
California is a brewing hotbed of potential trouble when it comes to insurance rates. California lawmakers propose a state-wide vote on a new ballot initiative that would expand the state's authority to regulate health insurance rates. To make matters worse, voters show signs they support the measure, according to an article in Kaiser Health News.
Aetna is closing the doors of its CarePass mobile platform--a unique mobile approach in the insurance industry that garnered widespread support and collaboration from mobile companies, including FitBit--by the end of the year. It has abandoned all plans for the project.
Insurers should start their outreach and marketing early as there are almost 7 million people who are eligible to enroll in a plan sold on the health insurance exchanges before the next open enrollment period begins on Nov. 15, says a new report from Enroll America.
Medicaid insurers are struggling to pay for pricey drugs, leading some to request states to increase payments so they can run their plans. Meanwhile, some states are deciding restrict the expensive medications.
Hold on to your seats and gear up for the most dramatic changes the health insurance industry has faced yet, says Aegis Health Group CEO Phil Suiter, in an exclusive interview with The Tennessean.
As the healthcare industry as a whole is moving toward a more consumer-centric mindset, this does not bode well for insurers who offer a list of only narrow-network providers.
Some state officials want more regulatory authority over Medicare Advantage plans. Right now, state regulators can't impose sanctions on Medicare Advantage plans; only the Centers for Medicare & Medicaid Services has that power.
Insurers hoping to have the option of selling a new plan on the health insurance exchanges just got a boost for their cause: The so-called "copper plans" could reduce federal healthcare spending by $5.8 billion over the next 10 years, according to an analysis released Tuesday from Avalere Health.
Thinking outside of the box has helped two wellness programs achieve success, including lowering claims costs and helping participants lose weight.
The Affordable Care Act is sparking competition among healthcare insurers and providers, as insurers make moves to become healthcare providers, reports NPR.
Accountable care organizations often involve high-need, high-cost patients, which can make for a very expensive and challenging program to manage. But a team of researchers has identified effective ACOs that successfully implement complex care management (CCM) interventions that insurers and providers can use to bolster their own programs, lower costs and improve care.
As insurers are covering more preventive tests and screening, as required by the Affordable Care Act, two financial experts question whether such coverage actually incurs additional costs for the companies.
More young adults have been receiving treatment for mental health conditions since the ACA allowed them to remain on their parents' plans until they turn 26 years old.
Non-profit insurers will soon be the dominating type of insurance company due to competition fostered by the Affordable Care Act, says industry watchdog Wendell Potter. If for-profit insurers want to remain viable in the post-ACA market, the former Cigna exec says they must diversify by operating outside the United States and expanding their business lines.
A new analysis shows healthcare payers may face a rocky road as recent legal battles continue to brew over ACA subsidies.
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.