Minnesota: State-created insurer can keep records private

The court stated that the Minnesota Joint Underwriting Association "clearly and unambiguously is not a state agency."

By Heather Caspi • April 10, 2015

Aetna fined $1M for Part D network error

Aetna's complaint rates for Part D issues were five times those of all Part D parent organizations.

By Katie Bo Williams • April 9, 2015

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

Inside the controversial transition to a new Medicare Advantage risk-adjustment model

According to one report, the new model will result in a 23% reduction in plan payments for people with chronic kidney disease.

By Julie Henry • April 8, 2015

More insurers restrict morcellator use following FDA warning

"Plans are looking very seriously at this," AHIP president Karen Ignagni said. 

By Heather Caspi • April 8, 2015

Socioeconomic risk adjustment divides issuers, industry

A new RWJF report identified three challenges to payment reform—one of which is risk adjustment based on social determinants. 

By Heather Caspi • April 8, 2015

UnitedHealth to develop healthy vending machines

"We're trying to build startups and when we're in these adjacent spaces outside the core of our businesses, there's a lot of uncertainty," said UnitedHealth's VP of innovation.

By Heather Caspi • April 8, 2015

Report: Private exchange enrollment doubled in 2015

...but some analysts note that the new projected growth increments actually represent a slow-down from last year's report.

By Heather Caspi • April 8, 2015

Aetna launches campaign to target LGBT customers

"This is a pilot for us to really understand how people are making choices and thinking about purchasing healthcare," Aetna president Karen Rohan said.

By Heather Caspi • April 8, 2015

Will Nevada ban its state insurance exchange?

Two Republican-sponsored bills proposing to do just that are at odds with the state's governor and the exchange's 74,000 latest enrollees.

By Heather Caspi • April 8, 2015

Survey: Providers, vendors still unprepared for ICD-10

"Unless all industry segments make a dedicated effort to continue to move forward with their implementation efforts, there will be significant disruption on Oct. 1, 2015."

By Julie Henry • April 7, 2015

Medicare Advantage payments to rise in 2016

According to CMS, insurers will likely see overall revenue increase by about 3.25%. 

By Katie Bo Williams • April 6, 2015

Docs vote 'no confidence' in CHI, may open indepedent hospital

CHI's CEO said he believes leaving a healthcare system to open a stand-alone hospital would be a risky move for the disgruntled physicians. 

By Julie Henry • April 6, 2015

NJ insurers fight for change to out-of-network payment rules

Health insurers say existing rules requiring them to pay for emergency care at full charge rates are imposing heavy costs.

By Anne Zieger • April 2, 2015

Lackluster sign-ups in special enrollment period

Enrollment expert Charles Gaba estimated 220,000 would have signed up by March 29.

By Katie Bo Williams • April 2, 2015

UnitedHealthcare changes balance billing policy

Insurers are taking different approaches to out-of-network providers at in-network facilities.

By Heather Caspi • April 1, 2015

Colleges dumping student health insurance plans

As a result, some students may now be looking to the marketplace.

By Heather Caspi • April 1, 2015

Humana strategy bets big on narrow focus

The company is refining its offerings and leaving many to wonder what it will do next.

By Heather Caspi • April 1, 2015

Premera facing 5 breach lawsuits

All five suits include allegations that Premera failed to protect their customers' personal data leading up to the breach that impacted 11 million.

By Julie Henry • April 1, 2015

Aetna drops prices for HIV and AIDS drugs

Pressure from advocates is likely to push other insurers to follow suit.

By Heather Caspi • March 31, 2015

Customers pressure Blue Shield of CA to lower rates

Blue Shield says it plans to remain a nonprofit, but has already lost its state income tax exemption.

By Julie Henry • March 31, 2015

Insurers show 'substantial' improvement in medical loss ratio compliance

MLR rebates dropped from $1 billion to $325 million in three years.

By Julie Henry • March 30, 2015

UnitedHealth to buy pharmacy benefits manager for $12.8B

"You have to have scale," said Catamaran executive Mark Thierer. "This makes the business more competitive overall."

By Katie Bo Williams • March 30, 2015

CO-OPs reach 1 million members

Analysis indicates CO-OPs are having an impact beyond their enrollment numbers—specifically on market premiums. 

By Heather Caspi • March 27, 2015

UnitedHealthcare considers split with two Connecticut hospitals

A contract dispute appears likely to run up against an April 14 deadline.

By Heather Caspi • March 27, 2015

Highmark delays paying claims, blames state

The insurer argues that a 2014 consent decree created confusion over when Highmark members can be treated at UPMC at in-network rates.

By Anne Zieger • March 26, 2015