Kentucky governor makes good on vow to shutter state insurance exchange

Bevin has already halted marketing for Kynect.

By Meg Bryant • Jan. 13, 2016

Late enrollments destabilizing market, insurers say

The Obama administration is addressing concerns special enrollment periods may be subject to abuse.

By Heather Caspi • Jan. 13, 2016

Explore the Trendline➔

Payer/provider relationships

As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.

By Healthcare Dive staff

Will AHIP survive major payer departures?

With the changing landscape of health insurance comes change in industry representation.

By Heather Caspi • Jan. 13, 2016

Humana says membership, revenue to drop this year

The insurer expects 300,000 members will drop their insurance coverage by the end of the year. 

By Nina Flanagan • Jan. 12, 2016

Hospitals continue to file lawsuits against HHS' two-midnight rule

Last Friday, more than 50 hospitals filed a lawsuit against HHS Secretary Sylvia Burwell over the controversial measure. 

By Nina Flanagan • Jan. 12, 2016

21 participants join new Next Generation ACO program

Allowing up to 100% financial risk, the new model includes a prospectively set benchmark and offers beneficiaries the choice to be aligned to the ACO.

By Heather Caspi • Jan. 12, 2016

UnitedHealth warns N.Y. of low rates following state's co-op failure

The insurer is taking issue with state regulators for factoring risk-adjustment payments into rate limits.

By Heather Caspi • Jan. 11, 2016

Idaho governor announces alternative plan to Medicaid expansion

State legislators support addressing the coverage gap, but not via the ACA.

By Heather Caspi • Jan. 11, 2016

Friday Rounds: Wheelin', dealin' and leavin' in the new year

The healthcare industry didn't waste any time kicking off the new year. Federal actions framed the week as one major insurer left the trade group AHIP.

By Jeff Byers • Jan. 8, 2016

LA governor sets ambitious plan for Medicaid expansion

Despite budget issues, the incoming democratic leader is targeting a summer expansion deadline. 

By Heather Caspi • Jan. 8, 2016

Federal watchdog warns of waste, lack of controls in ACA tax credit payment program

In response, CMS is pilot testing an automated process to address tax credit payments concerns.

By Meg Bryant • Jan. 7, 2016

Americans struggle to pay health bills even when insured

More than a quarter of insured Americans in a recent survey said unexpected claim denials made it difficult to pay medical bills. 

By Meg Bryant • Jan. 7, 2016

Health Affairs Blog: Standardized option for plans may benefit consumers, reduce discrimination

Standardized options would provide fixed deductibles, out-of-pocket limits, and standard copays and coinsurance for a number of essential health benefit services. 

By Nina Flanagan • Jan. 7, 2016

AHIP suffers major blow as Aetna departs

The company will not renew membership for 2016, marking a second hit to AHIP after United Health left last summer. 

By Heather Caspi • Jan. 6, 2016

Critical illness plans fill voids of skimpy health plans

Lump sum deals are being used to supplement otherwise high cost plans.

By Heather Caspi • Jan. 6, 2016

California approved for $6.2B Medicaid waiver

The state will be able to continue the massive transformation of its state Medicaid program.

By Heather Caspi • Jan. 6, 2016

HIPAA rule change aims to limit gun access

HHS’ HIPAA privacy rule update will allow mental health providers to identify patients subject to a mental health prohibitor barring them from shipping, transporting, or possessing firearms.

By Meg Bryant • Jan. 6, 2016

Uninsured hospital stays fell sharply in states that expanded Medicaid, study finds

New research published in Health Affairs could help influence states on the fence over expanding Medicaid programs.

By Jeff Byers • Jan. 5, 2016

ACA plans comp doctor visits to attract patients

Some marketplace health plans are using the tactic to stand out and, hopefully, lower costs down the line.

By Heather Caspi • Jan. 5, 2016

Health insurers look toward breaking down the big data walls

Siloed data are big barriers when it comes to health plans utilizing big data, but starting small and adding clinical value could provide the ROI insurers are looking for.

By Heather Caspi • Jan. 5, 2016

CMS, ONC open suggestion box on quality data submission

The agencies are looking to reduce the reporting burdens on providers and developers.

By Heather Caspi • Jan. 4, 2016

Keeping an eye on the prize: 8 healthcare topics to watch in 2016

From the 2016 presidential election to behavioral healthcare, the industry has its work cut out for it this year.

By Nina Flanagan • Jan. 4, 2016

CMS releases draft plan on quality measure development

Quality measures for new payment models will further promote provider accountability.

By Heather Caspi • Jan. 4, 2016

New Kentucky governor scales back stance on Medicaid expansion reversal

Stating the current incarnation is unsustainable, Gov. Matt Bevin (R) is exploring an ACA federal waiver option as opposed to dismantling the expansion entirely.  

By Heather Caspi • Jan. 4, 2016

CMS pushes back against risk score 'zombification'

The ACA's risk adjustment program, which shifts money between insurers, hinges on risk score credibility. 

By Heather Caspi • Dec. 23, 2015