Reimbursement
Insurers have to improve consumer education about drug formularies in exchanges, at the least, and some may even have to change their practices to meet new health reform standards.
Humana and DaVita are joining forces to try out a new way to serve high risk, special needs patients with a primary care-led model.
Indiana is pushing the bounds of Medicaid with the first-ever consumer-driven health plan for low-income populations. It's opening up new possibilities for other right-leaning states, but testing federal limits.
Health Care Transformation Task Force says 75 percent of the members will convert by 2020 as Medicare plans to tie 50 percent of payments to quality by 2018.
With and without government, some of healthcare's largest businesses, and those who pay for it, are mapping their own path to a critical mass of value-based payments.
State will pay for its share of the expansion costs beginning in 2017 with hospital fees and a cigarette tax.
Early adoption helps Massachusetts provider stay ahead as government mandates broader departure from fee-for-service.
One of the country's most promising new insurers could not be saved by state regulators. For some local advocates and insurance veterans, it is an opportunity lost to health reform policies gone awry.
More than a dozen Blues are trying to attract the next generation of members and help keep current customers as they age. To do that, they're invoking old school insurance ideas for the modern world.
The U.S. Department of Health and Human Services wants have 50 percent of Medicare reimbursements tied to quality and value by 2018, even if that includes fee-for-service.