Reimbursement
Unlike many local and state governments with steadily rising healthcare costs and a looming Cadillac tax, Houston is saving a fair amount with an accountable care network and wellness program.
If the time for precision medicine is now, could the massive databases of health and drug plan claims systems be a starting point?
Though it's been a booming first quarter for the major for-profit health insurers, the smaller two of the big five are not booming quite as much.
Medicaid managed care specialist Centene nearly doubled its quarterly profit, wrapping its arms around more and more members while adding fuel to rumor fires about the next wave of takeovers.
Aetna is again showing that the new insurance market, along with the business of health reform, can be profitable.
The plan claims to give employers the potential to save up to 15 percent over Aetna's traditional broad provider network plans.
Baptist made money doing what used to be industry heresy: reducing patients' use of the medical system.
Qualitest survey found 28 percent of organizations said they have done any revenue impact testing with payers.
For sale: Historic health insurance company with one million customers, $2 billion in revenue, some recent losses and mixed customer satisfaction, plus a modestly profitable voluntary benefits unit.
For both insurers seeking value and health systems pursuing all things integration, there is a huge conundrum waiting for an intervention: the hospital facility fee.