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Thousands of families with a disabled or deceased parent may have received a lower subsidy than they deserved to buy health coverage through the federal insurance marketplace as a result of a calculation error by the federal government. MORE
Add Tennessee and Kansas to the list of states that have been warned by the Obama administration that failing to expand Medicaid under the Affordable Care Act could jeopardize special funding to pay hospitals and doctors for treating the poor. MORE
It's a network war with Midwest manners, but Nebraska's largest insurer and health system still have miles to go before a resolution. The impasse may be hurting one organization more than the other. MORE
Consumer advocates and an activist insurance commissioner in California are renewing a push for premium review authority, while the state exchange is moving ahead with its own version of active purchasing. MORE
For Humana, the national insurer with the most Medicare Advantage members, retail health clinics are out of the integration strategy, but home care is very much in. MORE
Illinois' largest health insurer is building out its accountable care network, even as some of the health system partners are consolidating. MORE
Taking a cue from car manufacturers and cell phone companies, some providers are starting to see value in guaranteeing a standard for quality and costs. MORE
Despite the government's push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices. MORE
In a new oncology program in Florida, Aetna is trying to combine the medical home model with access to advanced care and translational research. MORE
What does managed care even mean these days? As the field has ballooned, its substance has been diluted, though it will still be useful in the new healthcare economy. MORE
The largest publicly run health plan in the nation, L.A. Care, is letting customers who do not have traditional bank accounts to pay their health insurance premiums with cash. MORE
With another round of venture capital, Oscar Health Insurance is getting ready to enter new markets and try to become more than just a niche concierge health plan. MORE
Despite facing concerns about conflicts of interest, former UnitedHealth Group executive Andy Slavitt wants to blend the best of the private and public sectors in a bid to optimize the $1 trillion-plus health plans covering 140 million Americans. MORE
What constitutes reasonable limitations and management of contraception as an essential preventive health benefit? In the wake of new data and some consumer complaints, HHS may try to resolve gray areas. MORE
Kicking off the spring season of managed care earnings statements, UnitedHealth Group shows that business is bustling for modernizing American healthcare and expanding insurance. MORE
The Equal Employment Opportunity Commission is offering businesses long-awaited guidance on employee wellness programs, condoning controversial financial incentives while also raising some questions about other practices. MORE
In an effort to make comparing hospitals more like shopping for refrigerators and restaurants, the federal government has awarded its first star ratings to hospitals based on patients' appraisals. MORE
Greater Philadelphia's largest insurer ended 2014 with a healthy margin, if one lower than a year before, and a portfolio full of new products and ventures. MORE
American healthcare does not need more technology, but leaders to think about systematic problems and how to create solutions for consumers, argues the CEO of Humana. MORE
A fresh stream of data is raising some concerns about a new class of diabetes medicines and their relation to long-term heart health. MORE
UnitedHealthcare is testing the waters of consumer rewards and digital engagement, in a new partnership with Walgreens that's aiming to spur better health choices. MORE
A sustainable Medicare payment for home-based medicine is on the horizon, and some insurers are already major backers of the service. But health plans could be doing more, especially in Medicare Advantage. MORE
Despite some lulls, the war between the University of Pittsburgh Medical Center and Highmark is again raging, now with a battle over Medicare Advantage plans and oncology reimbursement. MORE
How far can private exchanges go? New data suggest a large migration is in the works, even as the model brings some uncertainties for employers and insurers. MORE
To fix financial woes, New York City's taxpayer-owned health system is plotting a comeback and planning to give more residents a kind of public option for health insurance. MORE
As consumers increasingly are being asked to pay a larger share of their health bills, a coalition of insurers, pharmaceutical companies and provider and consumer advocacy groups launched a new push for greater transparency about the actual costs of services. MORE
The Blue Cross Blue Shield brand may bring the idea of a consistent kind of health insurance, as the winner of one "health plan brand of the year" poll. But in Medicare Advantage satisfaction ratings, that is not the case. MORE
Just as rival Humana exits the market, UnitedHealth Group is growing its portfolio of retail health clinics, in another step towards insurer-owned healthcare delivery. MORE
A 2008 federal law was supposed to ensure that when patients had insurance benefits for mental health and addiction treatment, the coverage was on par with what they received for medical and surgical care. But until now, the government had only spelled out how the law applied to commercial plans. MORE
For the third year, regulators have revamped reimbursement reductions into an average increase for Medicare plans serving America's growing senior populations, though not without requiring more work and oversight. MORE
Horizon Blue Cross Blue Shield of New Jersey is on the trail of all things data, with a new executive position given a charge of making sense of it all, plus some other major comings and goings. MORE
The likes of Lowe's and Walmart are moving ahead with the providers of excellence bundled payment model, applying it to a costly surgical treatment that's being marketed to an aging workforce with a low back pain epidemic. MORE
One health system is getting on the wave of health transparency and posting price estimates, although it still comes with barriers to patients shopping around for health services. MORE
A lot of health insurers still have many miles to go on the road to parity for consumers seeking mental health and substance abuse treatment, patient advocates maintain. MORE
New evidence from Massachusetts suggests that expanded health insurance may not bring the needed benefits of reduced hospitalization, and could spur a rethinking of cost-sharing for valuable primary care. MORE
As the palliative care movement grows, more and more physicians feel that so much effort is spend trying to extend life that few focus on what patients want in their last days. MORE
Even though consumers are digging deeper to cover rising out-of-pocket medical costs, they're contributing less to health savings accounts that could help take the sting out of their expenses. MORE
The perpetrators of an alleged Medicaid and Medicare fraud involving complimentary shoes and fake diagnoses could face 25 years in prison, as investigators across the country try to prevent or at least find fraud schemes that never seem to end. MORE
Pennsylvania's largest insurer and newest integrated delivery network operator took a financial loss for the second year in a row, but that may actually help if scrutiny of its nonprofit status continues. MORE
Can Anthem, the insurance giant famous for the for-profit Blues, "reconceive Medicaid as a care-delivery model rather than as an insurance program"? MORE
Are exchange insurers failing to adequately cover mandated tobacco cessation at no cost-sharing, or just not explicitly highlighting the benefits? MORE
Across the Mississippi River from a bankrupt cousin, a Midwestern cooperative insurer is entering year two with a sizable membership that will test its model of partnering with hospitals. MORE
Health insurers in New Jersey are complaining of a cost crisis arising from regulations meant to protect patients receiving emergency healthcare and involuntary out-of-network treatment. MORE
America's largest insurer is looking for all the scale it can get in the war for affordable medicines. MORE
There is a fair amount of hope for private health insurance exchanges in the commercial group market, but a pure defined contribution option will actually require a quite disruptive change. MORE
After the Affordable Care Act, Mississippi became the only state in the union where the percentage of uninsured residents has gone up, not down. MORE
American employers are spending more on wellness programs than ever, but also backing away from penalties, as consumers respond with skepticism and researchers keep probing ROI evidence. MORE
Cigna is looking for business in younger, yet-to-retire baby boomers in California, anticipating the benefits of streamlining the path from group health plan to Medicare Advantage. MORE
Amid a possible bipartisan break in the clouds of Congress, insurance advocates see a window for changing or even repealing the much-loathed health insurance tax in the Affordable Care Act. MORE
Staring down the sometimes troubled and opaque past of medical devices, and upward trend in spending, one national insurer is trying to build momentum for a universal way to compare and track outcomes. MORE

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