Reimbursement
The Centers for Medicare and Medicaid Services and the State of Rhode Island are contracting with a Medicare-Medicaid plan to provide integrated benefits to approximately 30,000 eligible enrollees.
People enrolling in public health insurance exchanges are more willing to switch plans, placing pressure on insurers to continually win over shoppers based on price, product and service, according to a new report by Deloitte.
While hospitals in Maryland have not brought down the state's total costs of care, the all-payer system seems promising enough to state and federal leaders under universal healthcare coverage.
Seven years after Congress passed a landmark law banning discrimination in the treatment of mentally ill people, many families and their advocates complain it stubbornly persists, largely because insurers are subverting the law in subtle ways and the government is not aggressively enforcing it.
Under Hemingway Hall, HCSC's insurers added 3 million in membership, including in ACA exchanges, and the company tried to adapt and diversify, including adopting new information technology and preparing to contract in Medicaid.
Pat Hemingway Hall, one of the most successful female executives in the health insurance industry, is leaving behind a giant nonprofit company that is still evolving.
A few reasons why the want-to-be cholesterol blockbuster Praluent will not be as much of a "budget buster" as the medicine that cures most hepatitis C patients.
In addition to the payment change, CMS said it will begin penalizing skilled nursing facilities in 2018 that fail to report quality measures as part of the agency's shift towards value-based reimbursement.
Assurant is advancing plans to wind down its once-profitable health insurance business, though apparently has not found a buyer for it.
Like most mergers and acquisitions, the Aetna-Humana and Anthem-Cigna deals will need a fair amount of cultural alignment to yield the market complementaries and business synergies being promised amid the record-breaking valuations.