News

'60 Minutes' accuses insurers of denying mental health claims

The news magazine 60 Minutes said on a recent show that insurers are denying mental health claims for patients in need of chronic long-term mental healthcare. In fact, the show said Anthem had more than a 90 percent denial rate for mental health claims, according to CBS News.

In 2015, ACA focus shifts to employer mandate, compliance

After a busy year, in 2015 the focus of the Affordable Care Act will primarily shift to the employer mandate and related compliance issues.

Small businesses continue to drop coverage for employees

Companies with fewer than 50 workers are not required to offer health insurance to their employees. As a result, many small business are dropping coverage for their employees. Instead, they are encouraging workers to purchase individual plans on Healthcare.gov. 

Large employers bearish on private health insurance exchanges

After attracting big-name employers such as Sears and Walgreens last year, private health insurance exchanges failed to sign up any major companies for 2015, according to Reuters.

So far, so good for Healthcare.gov as enrollment deadline looms

Millions of consumers who purchased health insurance during the last open enrollment period must decide today whether they want a new plan beginning Jan. 1, 2015.

High-risk pools aren't good option for expanding health coverage

Establishing new national high-risk pools like the pre-existing condition insurance plan under the Affordable Care Act isn't a good alternative to expanding ACA coverage. That's because insurance works best when payers can spread risk evenly across a large population, according to a new issue brief from the Commonwealth Fund.

Health insurance will go digital, eventually

Whenever my wife and I receive a health insurance statement in the mail, we begin a familiar ritual. I open the envelope, show the contents to my wife and ask, "You want this?" She shakes her head. I walk downstairs and add it to the growing pile that I'll stuff into a manila folder in a file cabinet that, at this point, is far too heavy to move. This scenario plays itself out all too often at my house--and probably at yours.

Two major technology trends will shape the future of health insurance

With 2014 drawing to a close, the health insurance industry has its eyes set on 2015 and beyond. Big data and wearable tech, among other things, have the capacity to revolutionize health insurance.

Health insurers brace for last-minute exchange enrollment rush

With Monday's deadline for re-enrollment in Obamacare health plans looming, insurers are preparing for the possibility that million of customers could change plans.

Nearly 90 percent of insurers embracing IT to handle challenges, opportunities

As insurers continue adopting new payment models and benefit designs, more than 88 percent said they will use health information technology to transform their organizations, according to a new survey from HealthEdge. 

Spending bill saves Blues plans millions--but no other insurers will benefit

The GOP spending bill, which the House passed last night, contains a provision that benefits Blue Cross Blue Shield insurers--but not other insurance companies.

How Aetna harnesses its data to help breast cancer patients

Payers have so much data available to them that they can create all kinds of valuable programs and projects that serve their members.

 

That's the belief driving Aetna CarePal, a pilot program that connects members who have recently been diagnosed with breast cancer to members who have already survived the disease. 

Senate approves Vitter's ACA amendment

The Senate Republican Conference approved Sen. David Vitter's (R-La.) proposal that requires members of Congress and their staffs onto the Affordable Care Act's exchanges.

Insurance exchange customers pick higher-premium plans

Premiums are up but deductibles are down in the early weeks of open enrollment for consumers using the federal exchange to shop for unsubsidized plans, according to survey data released by eHealth Inc.

States could forestall King v. Burwell outcome, but it won't be easy

Ever since the Supreme Court announced that it will hear King v. Burwell to determine the legality of the Affordable Care Act's subsidies, there has been a lot of speculation as to how the ruling will play out. Affected states could offset the case's outcome by building their own exchanges--but that's easier said than done.

Insurers slam GOP spending bill for capping risk corridor payments

Insurers are blasting a Republican-backed Congressional spending bill, saying it will cut vital federal payments and lead to an increase in healthcare costs.

Health IT can't evolve to handle toughest insurance industry challenges, execs say

Insurance executives don't think that health information technology analytics can evolve to help their companies address their top challenges of regulatory compliance, value-based reimbursement, and patient-centered care, according to a recent survey from consulting company Genpact.

Public, private exchanges use decision support tools to help consumers pick plans

In an era where healthcare consumers shop around for their best insurance options, technology and healthcare firms increasingly use decision support software to help people find optimal coverage.

Health insurance premiums up 73 percent in last 10 years

Premiums for employee-based family health insurance plans increased 73 percent from 2003 to 2013, and employer contributions to those plans jumped 93 percent, according to new research from the Commonwealth Fund.

Health insurance growth outlook 'stable' for 2015, Fitch Ratings report says

U.S. health insurers and brokers can expect solid margins and return on capital next year, Fitch Ratings announced.