Reimbursement

Among the near-poor, the proportion of the newly insured who gain their insurance through the marketplace was likely to be particularly high.

Customers and healthcare providers are accusing Blue Cross Blue Shield companies of exploiting the franchising model to inflate premiums and unfairly control market share, according to lawsuits that threaten Anthem's M&A strategy and could empower health systems and other insurers across the country.

The U.S. Supreme Court has dismissed the challenge to the Affordable Care Act's subsidies in federally-facilitated exchanges, a victory for the Obama Administration but certainly not the last health reform battle.

The Blues have been accused of running health insurance like a mafia for years, but now lawsuits could stick and compromise the family's future.

To ease the financial burden, the California agency that governs the state's Affordable Care Act marketplace issued landmark rules recently that will limit the amount anyone enrolled in one of those plans can be charged each month for high-end medicine.

Despite looming consolidation, health plans and insurers broadly need to attract more younger workers as Baby Boomers retire and markets evolve.

There will soon be one less member company of America's health insurance trade group, a sign of the industry's evolutionary turmoil.

The country's largest state insurance exchange wants to be an active purchaser negotiating on behalf of consumer, and a data-driven convener of affordability and quality.

Speakers at the Healthcare Management Association 2015 Annual Institute warn providers to embrace models like capitation, accountable care and bundled payments.

Oregon's top health insurance regulator is taking the unusual step of encouraging higher premiums in a competitive individual market, where the lowest-cost plan may also be the most disruptive.