Reimbursement

Assurant, one of the most profitable home and life insurers, is advancing its plans to leave the health insurance business and sell off a subsidiary in an attempt to cut its losses on the sector.

Picking the right insurance plans for your budget and health needs is challenging. Weighing monthly premiums and co-pays against yearly deductibles and comparing the benefits different plans offer can make your head spin, especially if you are newly insured.

Another ACA-funded co-op is going under, dissolving rather than confront an "unhealthy future." Many of the others are also struggling to stay in the black.

CMS recently released the long awaited risk adjustment filtering logic for the Medicare Advantage Encounter Data Processing System, requesting comment by August 21. This logic is an important factor in the future of risk adjustment.

Premiums for 1.3 million Covered California consumers will rise an average 4 percent, slightly less than last year's increase of 4.2 percent.

Total Medicaid revenues for these MCOs soared 103 percent to $110.6 billion in 2014 from $54.6 billion in 2010, according to a study by Milliman.

A "sleeper" provision when Congress created Medicare in 1965 to cover healthcare for seniors, Medicaid now provides coverage to nearly one in four Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money.

Anthem will buy Cigna for $54.2 billion, the insurer announced on Friday, in a deal that will reduce the former "Big Five" private health insurers to just three.