Clinton plans to help small businesses provide health coverage

The Democratic presidential nominee will propose an expansion of a currently under-utilized healthcare tax credit.

By Heather Caspi • Aug. 24, 2016

Not so different after all: Losses lead Oscar to market pull-outs

The insurer is increasingly adopting strategies akin to those of its rivals.

By Heather Caspi • Aug. 24, 2016

CBO: Aging population, drugs driving federal healthcare spending

This year will be the first time the annual budget shortfall will increase since 2009.

By Ana Mulero • Aug. 24, 2016

Companies managing Medicaid in Iowa losing millions

Managed care is supposed to save money, but early losses suggest payers could raise rates when they renegotiate contracts.  

By Luke Gale • Aug. 24, 2016

New York's HealthNow settles over $1.6M in denied behavioral health claims

Mental-health parity continues to be an issue in New York and around the U.S.

By Heather Caspi • Aug. 23, 2016

Blue Cross and Blue Shield of NC duking it out with state regulators on IT complaints

The N.C. Department of Insurance said the insurer has racked up 3,444 complaints so far this year.

By Heather Caspi • Aug. 23, 2016

Here are the hospitals that received $1.5B from CMS to clear Medicare appeals backlog

The payments went to over a third of U.S. hospitals.

By Jeff Byers • Aug. 23, 2016

OCR puts organizations on notice for smaller data breaches

Expect to see more HIPAA settlements as HHS steps up investigations of smaller breaches.

By Meg Bryant • Aug. 23, 2016

Aetna/Humana deny DOJ's antitrust allegations

The insurers argued the DOJ has failed to understand that Medicare Advantage plans are "privately administered managed care products."  

By Ana Mulero • Aug. 22, 2016

Reinsurance key for risk adjustment, stabilizing marketplace, research finds

Only 1% of patients in the 2013 sample group were very costly but they accounted for 28% of total annual healthcare costs.

By Ana Mulero • Aug. 22, 2016

Study finds massive California coverage increase under ACA

The majority of Californians who were uninsured before the ACA are now covered, KHN found.

By Heather Caspi • Aug. 22, 2016

Here are the challenges providers can expect with CPC+

To expand the initiative, CMS will need to offer incentives that attract payers and providers in other parts of the country, particularly in areas where there are large at-risk populations, one expert says.

By Meg Bryant • Aug. 22, 2016

Avalere: Insurer exits to bring steep drop in marketplace competition

The U.S. may see its number of rating regions with 0-1 carriers shoot up from 4% to 36%.

By Heather Caspi • Aug. 22, 2016

On patient steering from Medicare/Medicaid to marketplace plans, CMS wants answers

Regulatory changes could be coming to stop providers seeking higher reimbursement rates.

By Heather Caspi • Aug. 22, 2016

Minnesota 'distress call' asks more insurers to join exchange

With just three months to go until open enrollment, the state's move suggests desperation.

By Heather Caspi • Aug. 22, 2016

Anthem Blue Cross rolls out Spanish-speaking telehealth feature

The number of Hispanic Spanish speakers in the U.S. is expected to be 40 million in 2020, according to Pew Research.

By Meg Bryant • Aug. 19, 2016

Public health exchanges: One carrier's loss is another one's gain?

More than 1.8 million people will need to enroll in new health policies on the ACA public exchange market for 2017 — creating opportunities for some insurers. 

By Meg Bryant • Aug. 19, 2016

ACA's newly insured filling more Rxs, while seeing costs go down

Prescription use was highest among previously uninsured people who had at least one of five major conditions.

By Meg Bryant • Aug. 19, 2016

Feds hope to woo new consumers to Obamacare

A new outreach effort comes as several major insurers are scaling back participation in the public health exchange market.

By Meg Bryant • Aug. 19, 2016

EHR vendors continue to push the nation closer to interoperability

Carequality Interoperability Framework now covers more than 200 hospitals and 3,000 clinics in the U.S.

By Meg Bryant • Aug. 18, 2016

Florida Blue touts 'intimate' ACA market knowledge as key to success

The insurer poses a contrast to the major national insurers citing massive marketplace losses.

By Heather Caspi • Aug. 18, 2016

'We were off': A view of the ACA markets from a regulator's side

In the wake of Aetna's ACA exit announcement, new federal action is making moves to help strengthen the markets.

By Jeff Byers • Aug. 18, 2016

Oscar discloses $52M in losses in New York state

The company is working to stem its losses after a rough first half to 2016.

By Heather Caspi • Aug. 18, 2016

Kaiser is 'absolutely' staying with ACA exchanges

Aetna and other insurance giants have recently announced they will be dropping out of some of the exchanges.

By Ana Mulero • Aug. 18, 2016

CMS supports modular approach to Medicaid IT improvements

The aim is to increase state’s ability to upgrade Medicaid Management Information Systems and speed access to enhanced federal financial support.

By Meg Bryant • Aug. 18, 2016