Reimbursement

Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, and those cutbacks will affect customers in 37 states, according to the foundation.

Republican said he would curtail the state's expansion of Medicaid by seeking a waiver for a more restrictive version of the program.

In the first part of this series, we looked at a transformative year in healthcare and presented the ongoing shift from the Risk Adjustment Processing System to the Encounter Data Processing System. Here we present submission deadlines and what success does, and doesn't mean, so plans are not surprised when a high acceptance rate results in unexpected file rejections or a lower than estimated risk transfer or reinsurance payment.

In our last column, we took a look at how U.S. health plans operate in a world of rising expectations based on: value-based reimbursement; consumerization; healthcare cost management; and regulatory compliance. In this second part of the series, we'll give the best strategic plan of attack for each of these four trends.

U.S. health plans today operate in a world of rising expectations. They must work to contain rising healthcare costs, while at the same time catering more to consumers as the ultimate users of their products, rather than solely satisfying the demands of employers.

The Centers for Medicare and Medicaid Services will pay for end-of-life services, bringing to a close a debate that started with false "death panel" claims during negotiations over the Affordable Care Act and is ending with coverage for families so they can discuss the care patients receive when they are dying.

The average 2016 premium for a 40-year-old in Anchorage is $719 a month - more than double the national average, according to an analysis by the Kaiser Family Foundation.

HealthPlus of Michigan is merging with Health Alliance Plan, forming a larger, competitive plan while bailing out the struggling HealthPlus business.

As the open enrollment period for health insurance through the state and federal marketplaces got underway on Nov. 1, Kaiser answers plan questions.

Montana has become the 30th state to expand Medicaid, with federal officials on Monday signing off on a plan to expand coverage to low-income residents through a federal waiver that requires beneficiaries to pay premiums of up to 2 percent of their income.