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The ambitious new value-based healthcare coalition, including Aetna and HCSC, is wasting no time dispersing ideas. Consensus on reform may be difficult, and the work ahead even more so. MORE
When Ken Fasola was working at Humana and UnitedHealth Group in the 1990s and 2000s, the industry saw individual insurance products as "the bottom end of the food chain." MORE
Insurers have to improve consumer education about drug formularies in exchanges, at the least, and some may even have to change their practices to meet new health reform standards. MORE
Humana and DaVita are joining forces to try out a new way to serve high risk, special needs patients with a primary care-led model. MORE
Indiana is pushing the bounds of Medicaid with the first-ever consumer-driven health plan for low-income populations. It's opening up new possibilities for other right-leaning states, but testing federal limits. MORE
With and without government, some of healthcare's largest businesses, and those who pay for it, are mapping their own path to a critical mass of value-based payments. MORE
One of the country's most promising new insurers could not be saved by state regulators. For some local advocates and insurance veterans, it is an opportunity lost to health reform policies gone awry. MORE
More than a dozen Blues are trying to attract the next generation of members and help keep current customers as they age. To do that, they're invoking old school insurance ideas for the modern world. MORE
The U.S. Department of Health and Human Services wants have 50 percent of Medicare reimbursements tied to quality and value by 2018, even if that includes fee-for-service. MORE
One state's home-grown approach to health reform has produced a few discrepancies in the implementation of the Affordable Care Act, including one big dispute between insurers over risk-sharing. MORE
Are the two biggest forces in American healthcare, health insurers and health systems, investing enough in research and development? MORE
Cigna is acquiring a hospital-owned managed care company that serves a fairly diverse customer base of employers, providers and even potential competitors. MORE
In a deal showing just how massive and pivotal the quest is for digital modernization, Anthem is investing half a billion in a flexible, scalable cloud. MORE
Until corporate wellness programs demonstrate ROI, many companies have to consider whether there are other ways to improve the health of their employees and the country. MORE
The nation's third largest insurer is the latest to find a cheaper way to bring a curative therapy to members with Hepatitis C. MORE
Notwithstanding resistance in California and some long-term uncertainty, the nation's largest insurer is pretty stoked about 2015, public exchanges and Medicaid. MORE
In a crowded market dominated by the Blues, a hospital-owned health plan is trying grow in tandem with Medicare and Medicaid enrollment, seeing potential in suburban Baby Boomers. MORE
At a time when prevention is being hailed as a key to health reform, indeed required as an essential health benefit, new evidence is questioning assumptions about the benefits and costs. MORE
Why the costs for an increasingly common surgery should vary so much across and within regions is the key question Blue Cross companies are trying to answer, as new research find that pricing swings are still the norm. MORE
What do Amazon founder Jeff Bezos and the Regence Blues have in common? A new subscription-based clinic network with a simple recipe for the Triple Aim and competition for the establishment. MORE
The nation's largest insurer could be shut out from the largest state insurance exchange, as regulators pursuing an active purchaser strategy try to nurture a loyal group of underwriters for the long-term. MORE
A network dispute could leave a quarter million Californians without access to a large, well respected health system, a story playing out across the country. MORE
Under a mantra of "consumer centricity," the nation's largest Blue Cross company is taking a long-view on America's changing demographics and insurance access points. MORE
Another co-op insurer is showing signs of struggle, if not financial collapse, as a state regulator steps in. MORE
The nurse turned hospital executive turned chief federal healthcare regulator is leaving the government. Now the industry is left wondering: Who will take the reigns in the Obama Administration's pivotal fourth quarter? MORE
For exchange goers who need specialty medications, navigating their options before committing to a plan can be confusing, a problem insurers need to address if they want to cultivate brand loyalty. MORE
In health insurance prices, as in the weather, Alaska and the Sun Belt are extremes. MORE
A few months ago, North Carolina's largest insurer was hesitant to reveal hospital payments on a state-mandated consumer information website. Now, it's making a bigger leap with its own online transparency initiative. MORE
If 2014 was a year of managing member populations who need a blockbuster treatment for hepatitis C, 2015 is turning out to be one of deals for everyone to access that drug. MORE
Is the nascent multi-state plan program a threat to health insurance competition, or possibly a surreptitious route to a public option? The Blues and co-ops will be how the market finds out. MORE
After a massive data breach at the Garden State's largest health insurer, carriers and others now have to comply with data protection standards that exceed HIPAA.  MORE
Insurers in one of the country's largest markets will now have to pay for telehealth, adding to the critical mass of reimbursement mandates and voluntary decisions for the service. MORE
The nation's third largest insurer is joining the ranks of the most progressive companies and promising its wage-based employees a livable income, while also investing in less-than-traditional benefits. MORE
Advocates of a radical reform solution are pointing to new evidence of the burdens of private sector administrative bureaucracy. MORE
Provider and patient advocates are worried about a Supreme Court case that could restrict the ability to sue over low Medicaid reimbursement rates. MORE
The corporate scions of American health insurance are making valiant, if risky, strides in the new ACA market. But their ratings still show the promise of their prowess. MORE
The first insurer to drop out of the Affordable Care Act exchange market after only a year is now trying to figure out where to go next. MORE
This year there are a lot of employment options, including public affairs gigs and management positions at provider-owned plans. MORE
The Affordable Care Act may be guaranteeing health coverage for millions of Americans, but the definition of affordability is under dispute and raising questions about the burden on middle class consumers. MORE
More affordability may be coming to the surging speciality pharmaceuticals space, as regulators move to approve the first generic-equivalent version of a biologic drug. MORE
Medicaid-focused managed care company Centene is adding to its portfolio a data-drive health engagement platform, a sign of the increasing interest in wellness for both commercial and publicly-insured populations. MORE
Amid a fractious public dispute with its chief rival, Highmark and its health system are making a community investment that, though unlikely to turn a profit, may reap returns in loyalty and reputation. MORE
Competition for treating America's hepatitis C population is intensifying among pharmaceutical companies and benefits management firms, suggesting a thaw in the $1,000 per-pill price of last year's blockbuster. MORE
The regulator of the nation's largest state market is taking a proactive, interventionist stance on the still fractious issue of network adequacy. MORE
In the fourth quarter of the Obama Administration, the nation's chief trade regulators are promising a healthy dose of scrutiny for the continuing waves of healthcare provider mergers and acquisitions. MORE
One of the Midwest's largest Blues is winning in the new insurance market under the Affordable Care Act, without even selling a public exchange plan. MORE
Two of Medicaid's top leaders are leaving the federal government, opening vacancies for chief regulatory positions amid a booming period of evolution in the program. MORE
Donna Giron is frail. She has Crohn's disease and uses a wheelchair to get around because walking exhausts her. But she doesn't want to be in the nursing home where she has lived since May. MORE
A mapping of the new individual market's variation in premium regulation show the evolution of a national market at once attempting to be standardized and amenable to state approaches. MORE
The nation's largest pharmacy chain is tweaking its accountable care experiments, ending some relationships and starting others, as it embarks on another more potentially-disruptive venture. MORE

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