News

Healthcare.gov CEO tells insurance commissioners to examine proposed 2016 rates

In an attempt to keep health insurance premiums affordable for consumers, state regulators have been asked to take a closer look at rate requests before granting them.

Cadillac tax--whether repealed or implemented--will affect insurers

As opposition against the Affordable Care Act's Cadillac tax is ramping up, we don't yet know whether the tax will be repealed, amended or go into effect as is. But one thing is for sure: insurers will be affected.

Medicare trust fund to run out by 2030, trustees say

The main trust fund that finances Medicare's hospital insurance coverage will run out in 2030, the program's trustees said in a report issued Wednesday, adding that while this is unchanged from last year's projection the long-term funding outlook has improved.

Health insurers see growth potential in urgent care business

Some of the country's major insurers are showing that health systems aren't the only industry players expanding their reach into the booming urgent care business.

UnitedHealth sells $10.5 billion in bonds to pay for Catamaran deal

UnitedHealth Group sold $10.5 billion in bonds Monday and used the nearly $40 billion in orders it received to pay for its recent $12.8 billion purchase of pharmacy benefit manager Catamaran Corp.

Debate continues whether insurers comply with ACA's transgender-coverage mandate

The Affordable Care Act mandates that health insurance companies cannot deny coverage to transgender individuals or those who are going through the reassignment process, but recently there's been debate whether insurers actually comply with this provision. 

Bill would block Massachusetts insurers from sharing private health info

A recently introduced bill in the Massachusetts legislature would prevent insurers from sharing private health information with anyone except the patient it concerns when several people are covered through one plan.

Maryland exchange to get $45M from contractor

The company primarily responsible for operating Maryland's health insurance exchange has agreed to repay the state and federal government $45 million to settle claims that it mishandled its duties, the Maryland attorney general's office announced Tuesday.

Medicare to test change in how it pays for hospice care

Medicare will test a program that changes how it pays for hospice treatment, for the first time allowing patients to receive both curative and palliative treatment, the Centers for Medicare & Medicaid Services announced.

Florida insurers want more money from the state to cover Medicaid patients

Florida reaped substantial savings after switching to privately managed healthcare for more than 3 million residents covered through Medicaid. But it's possible the savings--which accounted for nearly $9.5 billion of state spending last year--could soon disappear.

Health policy experts say Medicare is more efficient than Medicare Advantage

Although the Medicare Advantage program is widely popular among both insurers and consumers, several healthcare experts don't think Medicare officials should privatize the public insurance program any further.

Care coordination can help Medicaid stem costs of new enrollees

While a recent report indicated that newly eligible Medicaid enrollees may be more costly than anticipated to cover, a Health Affairs study points to one promising cost-reduction solution--care coordination.

How officials address the uncertain future of CHIP

After the Obama administration extended the Children's Health Insurance Program (CHIP) for another two years, officials already are looking ahead to 2017 and weighing options as to what to do should the program cease to exist.

Private exchanges may promote payer-provider collaboration

Employers' continued interest in private health insurance exchanges likely will lead to a boost in industry innovation and an increase in payer-provider collaboration, according to a new report from Leavitt Partners.

Oregon provider-payer hybrid aims to disrupt healthcare delivery

A 9-year-old health clinic network in Oregon that now is selling health insurance for the first time aims to challenge the healthcare system's status quo with its innovative model.

In memo to employees, Aetna CEO lauds deal with Humana

Perhaps trying to ease concerns about the company's impending merger with Humana, Aetna CEO Mark Bertolini reiterated the benefits of the deal in an internal memo to his employees. 

 

Major health insurers capitalize on population health

Amid consolidation throughout the health insurance industry, major payers continue to focus efforts on the increasingly popular trend of population health, which quickly became a multi-billion dollar effort.

How personal healthcare experiences shaped Aetna CEO Mark Bertolini's career

Even amid his long career in the health insurance industry, Aetna CEO Mark Bertolini says management style has been shaped perhaps the most by the time he spent in the hospital at his son's side and as a patient himself.

 

Budget woes continue for Medicaid expansion states

While more than a dozen states that chose to expand Medicaid have experienced enrollment success past projected numbers, that latest surge raises concerns that the pricey program is jeopardizing states' budgets.

Looking past King v. Burwell: Business implications for health insurance plans

For insurance plans, the King v. Burwell decision affirms tax credits will be available for the 6.4 million who might have lost coverage. It also has the immediate effect of temporarily stabilizing premiums and likely participation in the 19,000,000 enrollee individual insurance market. But beyond this, a number of issues and challenges relevant to insurers remain as part of the unfolding of the Affordable Care Act's implementation.