Today’s Headlines ▶

When Michael Kamins opened the letter from his health plan he was enraged by what he encountered, a part of critics see as medical necessity's "last hurrah." MORE
Billions of dollars have been spent on 90 deals over the past decade. See which five companies are responsible. MORE
Pat Hemingway Hall, one of the most successful female executives in the health insurance industry, is leaving behind a giant nonprofit company that is still evolving. MORE
Assurant is advancing plans to wind down its once-profitable health insurance business, though apparently has not found a buyer for it. MORE
Like most mergers and acquisitions, the Aetna-Humana and Anthem-Cigna deals will need a fair amount of cultural alignment to yield the market complementaries and business synergies being promised amid the record-breaking valuations. MORE
Another ACA-funded co-op is going under, dissolving rather than confront an "unhealthy future." Many of the others are also struggling to stay in the black. MORE
Premiums for 1.3 million Covered California consumers will rise an average 4 percent, slightly less than last year's increase of 4.2 percent. MORE
The cost of health insurance in California is going up by 4 percent for plans offered in 2016 on the Health Insurance Marketplace, a rate hike announced as "modest" by Covered California on Monday. MORE
A "sleeper" provision when Congress created Medicare in 1965 to cover healthcare for seniors, Medicaid now provides coverage to nearly one in four Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes. MORE
A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money. MORE
Anthem will buy Cigna for $54.2 billion, the insurer announced on Friday, in a deal that will reduce the former "Big Five" private health insurers to just three. MORE
Some analysts who have looked at health insurers' proposed premiums for next year predict major increases for policies sold on state and federal health exchanges. Others say it's too soon to tell. One thing is clear: There's a battle brewing behind the scenes to keep plans affordable for consumers. MORE
The public health pitch for making Medicare available at 50 comes with some strong evidence and business opportunity for population health. MORE
Amid a planned acquisition by Aetna, Humana is still going forward with new models, including an expanded deal with one of several promising primary care ventures. MORE
Primary care incentives for ACOs may not be strong enough to accomplish the goals of improving patient experiences, population health and high costs. MORE
With a progressive CEO and culture and a huge merger in the works, Aetna is promising to help reinvent healthcare. Yet it is still up against the long-term unknowns about what will constitute truly sustainable healthcare. MORE
Even though most people now take some steps to communicate their end-of-life wishes, many may still receive more intensive care than they would have wished. MORE
Far from being overtaken by a provider-led managed care movement, Molina is getting into the game. MORE
Sallyann Johnson considers herself a pretty savvy healthcare consumer. When she fell and injured her hands and wrists, she didn't head for an expensive emergency room, choosing an urgent care clinic near her Milwaukee home instead. MORE
In the Pacific Northwest, a new kind of health system, "with insurance built in," is trying to validate its primary care model and disrupt a seemingly competitive regional healthcare market. MORE
Which hospital parents pick to deliver their baby can have serious cost consequences, according to a new study. MORE
It's a situation that occurs all too often: Someone goes to the emergency room and doesn't learn until he gets a hefty bill that one of the doctors who treated him wasn't in his insurance network. MORE
More Americans than expected opted out of the individual insurance mandate, including some who didn't even have to. MORE
The latest deal by diagnostics company Theranos suggests that the old school and new school can collaborate, and that the Blues might have a little something up their sleeves. MORE
Instead of retiring, Marilyn Tavenner, the former nurse, hospital executive and Medicare administrator, is going to represent the economic and political interests of American health insurers. MORE
Few days went by last year when New Hampshire nephrologist Ana Stankovic didn't receive a payment from a drug company. MORE
Maryland same-sex couples who wanted to take advantage of a state law that requires insurers to cover pricey in vitro fertilization treatments used to face insurmountable obstacles. Not anymore. MORE
A Michigan hematologist will likely spend the rest of his life in prison after defrauding Medicare and private insurers, and violating the first tenet of medicine, "Do no harm." MORE
North Dakota’s largest health insurer has made a quick turnaround after a year of underwriting losses and lost technology contracts. MORE
James Colbert, MD, Harvard medical instructor and ACO Learning Network consultant, on the challenges and opportunities of designing high value networks and the data needed to do it. MORE
Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs. But the amount of those savings and the speed with which those savings occurred surprised researchers. MORE
Trying to bring affordable, painless lab tests to the masses, Theranos is breaking into a new market in collaboration with one of Pennsylvania’s major insurers. MORE
Not only are many hospitals getting sizable federal drug discounts, some may be over-prescribing, according to the Government Accountability Office. MORE
The case against Blue Shield of California’s tax-exempt status is growing, presenting an additional $40 million to the tax bill, but also the possibility of more drastic state action. MORE
While individual premium proposals for 2016 are still pending, data from the ACA exchange markets offer a backdrop to next year’s double digit increases. MORE
An old Yankee insurance company is taking over the younger, Louisville-based Humana. It’s a deep dive into Medicare, government-funded health plans and new ways of delivering and paying for healthcare. MORE
Gynecologists ordered fewer preventive services for women who were insured by Medicaid than for those with private coverage, a recent study found. MORE
The right to marry in any state won't be the only gain for gay couples from last week's Supreme Court ruling. The decision will probably boost health insurance among gay couples as same-sex spouses get access to employer plans, say analysts and benefits consultants. MORE
The U.S. Supreme Court has dismissed the challenge to the Affordable Care Act's subsidies in federally-facilitated exchanges, a victory for the Obama Administration but certainly not the last health reform battle. MORE
The Blues have been accused of running health insurance like a mafia for years, but now lawsuits could stick and compromise the family's future. MORE
Despite looming consolidation, health plans and insurers broadly need to attract more younger workers as Baby Boomers retire and markets evolve. MORE
There will soon be one less member company of America's health insurance trade group, a sign of the industry's evolutionary turmoil. MORE
The country's largest state insurance exchange wants to be an active purchaser negotiating on behalf of consumer, and a data-driven convener of affordability and quality. MORE
Oregon's top health insurance regulator is taking the unusual step of encouraging higher premiums in a competitive individual market, where the lowest-cost plan may also be the most disruptive. MORE
Taking a cue from Aetna, Ascension Health and companies beyond the healthcare industry, Tufts Health Plan is raising its minimum base wage. MORE
Anthem is scrambling to save a $53 billion takeover of Cigna, while encountering some deep criticisms of its own future potential. MORE
California health officials failed to ensure that more than 9 million residents enrolled in Medicaid managed care plans had access to doctors when they needed them, the state auditor said in a stinging report. MORE
Fallon Health is departing from Massachusetts’ Medicare-Medicaid managed care program, another sign that the sought-after benefits and savings will be hard to achieve. MORE
While pent-up demand and new individual customers have contributed to higher-than-hoped-for premium increases, extraordinary claims have been less than feared, leaving some more money to spread around. MORE
Massachusetts health insurers and their small business customers will have another year with a sort-of sharing risk rating system, although eventually they’ll be in for reckoning. MORE

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