Reimbursement

The seminal reporting period for Marketplace-participating plans has closed and the results are in. Where does the industry go from here?

An old Yankee insurance company is taking over the younger, Louisville-based Humana. It's a deep dive into Medicare, government-funded health plans and new ways of delivering and paying for healthcare.

If the $37 billion cash-and-stock deal is approved as a whole by regulators, Humana will bring Aetna's membership to more than 33 million.

With margins razor thin, hospitals are increasingly looking to transactions to achieve economies of scale and boost profitability.

Gynecologists ordered fewer preventive services for women who were insured by Medicaid than for those with private coverage, a recent study found.

For the 2014 benefit year, over $7.9 billion in reinsurance payments will be made to 437 issuers nationwide.

The right to marry in any state won't be the only gain for gay couples from last week's Supreme Court ruling. The decision will probably boost health insurance among gay couples as same-sex spouses get access to employer plans, say analysts and benefits consultants.

The study labeled 11 percent of plans "extra small" because they covered fewer than 10 percent of physicians in a plan's region. Another 30 percent were "small," meaning they covered between 10 and 25 percent of physicians.

Most organizations support the 6-3 vote to preserve federal subsidies.

Insurers can focus on optimizing individual plans with cost-comparison and provider-choice tools and value-based benefit designs, expert says.