Today’s Headlines ▶

The case for collaboration in accountable care networks is getting a boost in the Puget Sound region, where Humana had found a partner for a new Medicare Advantage network. MORE
The former chief financial officer of a now-closed Texas hospital is one step closer to a potential five years in federal prison after pleading guilty to wrongly claiming EHR incentive money. MORE
The Sunshine State's largest health insurer is betting on a well-branded telehealth service with a retail experience. MORE
A tension between transparency and trade secrets has surfaced in North Carolina, where the state's largest insurer believes a new disclosure law will have unintended consequences. MORE
The Obama administration took another step to close what many see as a health-law loophole that allows large employers to offer medical plans without hospital coverage and bars their workers from subsidies to buy their own insurance. MORE
The Medicaid private option policies designed to insure low-income individuals through a more market-based system is showing early signs of success, but also hurdles. MORE
Federal health officials and state exchange leaders may be pleased with enrollment and plan choices in many places, but long-term financing is a puzzle yet to be solved. MORE
Provider network controversies from the first Affordable Care Act enrollment are coming back to bite two large Blues in the second open enrollment, while raising questions about responsibility for consumer confusion. MORE
California's experiment aimed at moving almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance. MORE
Want to pay your health plan premiums while picking up medications, buying some batteries (or maybe a piece of chocolate) and getting a free cholesterol screening? Humana is betting that retail convenience will support its individual membership business. MORE
A new payer-led patient information exchange in California is getting ready to hit the ground running. MORE
Not only are employers prone to switching their health plans, but more are ending their group health benefits altogether, a sign of the growing importance of the individual market. MORE
One of the greatest concerns among patient advocates, regulators and insurers alike is that buying and using a health plan may be too complex a task for some consumers. One state exchange is hoping it found a scalable solution. MORE
Americans working to improve their eating and activity habits often fail, and not for lack of investment by employers, insurers and wellness vendors. Despite, or perhaps because of those challenges, Cigna is taking another crack at the problem. MORE
The nation's highest rated health plan is going through some growing pains and trying to make it to 2015 intact. MORE
Nationally, the new individual exchange market seems competitive going into its second year, with a variety of plans and reasonable premium increases. At the local level, though, consumers may experience some havoc. MORE
By most accounts, the federal marketplace that handles enrollment for 37 states is running well, but there are still uncertainties, notably millions of confused American consumers.  MORE
Though slower than the worst spikes of the last decade, American companies and their workers continue to see healthcare costs increases, putting pressure on insurers to respond with new exchanges and plan designs. MORE
More insurers are finding benefits in marketing new health plans with regional providers, as a way to leverage prominent brands, make networks more accessible and also create potential competitive threats. MORE
In the Affordable Care Act's second enrollment period, insurers and exchange will again try to lure the young adult demographic, a challenge that will test risk adjustment policies and the best minds in marketing. MORE
With new essential health benefit rules, some insurers are starting to take a more proactive approach to mental and behavioral health. MORE
Taking stock of its diversification strategy, the nation's largest health insurer is creating a new enterprise oversight unit, moving around some key leaders and saying goodbye to others, all before a big enrollment push. MORE
Large national insurers have gotten lots of attention for investing in new technology and acquiring startups, but as it happens the Blues are making some of the biggest waves in the digital health space. MORE
A new Republican majority focused on curbing regulation may give the healthcare industry the opposite of what most are looking for: uncertainty. Or they could turn to a fairly simple option to help the stakeholders long resistant to ICD-10. MORE
The California-based nonprofit health system and HMO Kaiser Permanente is hustling and bustling this year. MORE
Public exchange shoppers will have more choices this open enrollment period, and in some places, they're being courted with affordability, as insurers try to draw both first-time buyers and membership from rivals. MORE
Pre-reform underwriting approaches for speciality medications like HIV/AIDS drugs are not going to fly in the new health insurance market, as regulators and patient advocates intervene to challenge a range of practices. MORE
What was once thought to be a Hail Mary attempt by Affordable Care Act opponents is now starting to look like a clear pass with a chance of being caught. MORE
Despite backlashes against health screenings in corporate wellness programs, many Americans are open to a trade-off if it saves them money, though not necessarily lifestyle changes. MORE
More and more states are turning to all-payer claims databases to try to bring the ideas of transparency and shopping to reality. MORE
Federal officials are preparing the first major regulatory update to Medicaid managed care in a decade, promising to challenge insurers but also fix long-standing issues and offer routes to business standardization. MORE
Health insurers in the nation's largest market are breathing a collective sigh of relief after escaping a new rate review system, but they may have to fight the battle again. MORE
How will a long-time insurance manager fix the crisis in a state with some of the most expensive and advanced healthcare on the planet? MORE
A federal court is letting a wellness program's financial penalties take effect, but is considering the question of how much is too much, leaving corporate America and insurers waiting. MORE
In the quest for population health, lifestyle interventions for diabetes may pose the biggest rewards and most vexing challenges. Some are making progress, however. MORE
Already big and still growing, the U.S. healthcare system in 2015 will be scrutinized inside and out for signs of financial problems, the federal government's health investigator promises. MORE
Looking out at the transition to retail insurance and inward to its own efforts to develop consumer-focused services and technology, Aetna is investing in its own private benefits exchange.  MORE
All HIPAA-covered health organizations, and especially insurers, have been handed a small victory in the war of administrative simplification, as federal regulators once again back off a policy change long in the making. MORE
Embracing consumer-oriented healthcare, some providers are voluntarily adopting price transparency, while some insurers balk at proposed mandates to disclose their rates. MORE
For now at least, the employer mandate isn't going anywhere. But small businesses are flocking to a new market, leaving behind traditional models. MORE
Every organization looking at someone else's business thinks there is a tremendous amount of waste, and believes they could do it better if given the opportunity. This is just as true in healthcare as any other industry. MORE
Many health insurers have spent close to a century operating under fee-for-service and are now changing course. Some new payers founded post-health reform, however, are trying to hit the value-based ground running. MORE
Of all the things to try to build a better business for in healthcare, the nation's fourth-largest Blue Cross insurer is focusing on one of life's most crucial processes. MORE
Encouraging employer programs for health and prevention with one hand, the federal government is trying with the other hand to stake out a limit to what can be required of employees. And it's getting a bit fractious in the wellness space. MORE
Figuring out when members are covered by different types of insurance can be a struggle, or not even possible. It's a source of waste and confusion that some insurers are trying to root out. MORE
UnitedHealth continued its shopping spree on Tuesday with Optum, the group's technology and services subsidiary, agreeing to pay $600 million to acquire Alere Inc.'s condition management and wellness subsidiaries. MORE
The raison d'etre and central function of health insurers has had a slow time coming into the 21st century. But with both providers and patients demanding a better experience, the impetus for progress could bring a critical mass. MORE
Many years ago, there was a saying in American politics to describe an important bellwether state: "As Maine goes, so goes the nation." Today the state is still an important indicator, especially in healthcare.  MORE
Facing the fact that just 5 percent of the patient population was responsible for nearly half of its spending, one health organization has tried some fairly radical changes. MORE
Just as American society's views and acceptance of transgender issues are evolving, insurers are facing choices, challenges and uncertainty in adapting coverage policies for LGBT. MORE

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