Today’s Headlines ▶

The land of the Green Mountains, dairy farms and maple syrup is no longer pursuing the progressive dream of a single payer healthcare system, although it may still be on the vanguard trying to regulate affordability and access. MORE
One Medicare Advantage company offers a parable for what can go wrong in the business of managed healthcare. MORE
A fractious and potentially costly family of provider-led class action lawsuits are moving through courts, pitting accusations of illegal clawbacks againsts the likes of Aetna and UnitedHealth Group. MORE
Private physician practices may soon be a thing of the past, according to a new survey that shows them dwindling year over year as more doctors opt to become part of a hospital or health system. MORE
Deep inside the massive short-term spending bill awaiting President Obama's signature are provisions that could rattle the insurance industry. MORE
WellCare has been trying to shake off its past transgressions and grow amid speculation of being a target for acquisition, and now its executive suite is ready for business. MORE
The pressure is growing on Republican Governors to expand Medicaid in some way, and more state executives are turning to managed care and market-based approaches to bring in federal dollars. MORE
The nation's largest insurer is starting a new bundled payment pilot in oncology with one of the most prestigious providers in the field, in an experiment they hope will be yield beneficial evidence and grounds for expansion. MORE
One of the nation's largest health systems is struggling with its new health insurance business, leading to the first loss in 15 years. MORE
Once in a while, a key voice in the reform movement turns out to be a skeptic, arguing that the changes being implemented are too prone to producing more of the same. MORE
The latest salvo in the pharmaceutical price wars is being launched from an unlikely outpost, but one that represents the struggle to pay for the year's most successful drug. MORE
A young adult generation with college debt, limited assets and an uncertain job market who rarely need to use the healthcare system should be prime customers for low-premium, high-deductible health plans. Not so, some data suggests. MORE
A large handful of cooperative insurers created through the Affordable Care Act have lowered 2015 premiums in a bid to boost membership in their second year of operation, upsetting traditional insurers. MORE
A startup health insurer trying to capitalize on digital services and simplicity is now offering members wearable devices and incentives for activity, another step in its bid to disrupt health insurance. MORE
California's second largest nonprofit insurer is using a strategic acquisition to enter a growing, but challenging sector of government-funded health plans. MORE
Record low healthcare inflation does not seem to be trickling down to average middle income consumers with work-based insurance. If anything, more Americans may be questioning the value of their employer health plans amid wage stagnation. MORE
No deadline is ever really certain. The federal government is giving health insurers more time to submit data for the risk-sharing programs that many market reforms are depending on. MORE
In a way that is deeply changing federal contracting, growth opportunities from the government have increasingly come not from war but from healing. MORE
While some evidence suggests medical cost ratio mandates are helping make healthcare more affordable, there are still some long-term doubts.  MORE
Amid an intense debate about the cost and value of drugs, a big payer and a big pharma company are promising to comb through their collective evidence and deliver new knowledge that may improve patient outcomes. MORE
A population healthcare model in Mississippi that use telehealth technology to help curb the worst of diabetes has achieved early success and caught the attention of the state government. MORE
The 2015 open enrollment is off to a pretty good start and the new market is working, federal officials insist, but for consumers and insurers, there is still a tough slough, albeit of a different sort. MORE
With many health information exchanges showing mixed success, the impetus to start digital patient data sharing is increasingly falling on payers. Some of Colorado's largest insurers are heeding the call. MORE
Media attention about fines for business practices is one of the last things an insurer wants during open enrollment, but one state Blues is now faced with the task of damage control. MORE
Payers are cashing in on the mobile craze with apps to attract and ideally better serve customers. That can be a fraught pursuit, opening insurers to scrutiny and raising questions about the very experience they're trying to offer. MORE
Improving healthcare for the nation's Medicare-Medicaid dual eligible population seems to be just as complex as the beneficiaries' health needs, so state leaders are seeking help and more flexibility from the feds. MORE
Competition, innovation and regulation are spontaneously combusting in one unlikely state, as a company trying to upend HR and group insurance sales comes up against the law. MORE
Two health plans are being barred from further enrollment and another is being warned, as state regulators act on promises to ensure access and quality standards for beneficiaries. MORE
The long-standing problem of hospital-acquired infections, adverse events and medication errors is improving, new data suggest, although 1 in 25 hospital stays still comes with an infection. MORE
As some states try to overhaul their programs for Medicare-Medicaid eligible beneficiaries, Indiana is turning to managed care plans to improve services. MORE
After a year's worth of negotiations, a large health system is testing the limits of its clout and leaving a Blue Cross Blue Shield network, amid allegations of unfair reimbursement. MORE
A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans. MORE
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

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