Reimbursement

Notwithstanding resistance in California and some long-term uncertainty, the nation's largest insurer is pretty stoked about 2015, public exchanges and Medicaid.

In a crowded market dominated by the Blues, a hospital-owned health plan is trying grow in tandem with Medicare and Medicaid enrollment, seeing potential in suburban Baby Boomers.

At a time when prevention is being hailed as a key to health reform, indeed required as an essential health benefit, new evidence is questioning assumptions about the benefits and costs.

Program costs more than $140 billion, leaders say, but temporary 'doc fix' keeps physicians from serious reimbursement cuts.

Why the costs for an increasingly common surgery should vary so much across and within regions is the key question Blue Cross companies are trying to answer, as new research find that pricing swings are still the norm.

Judges to determine whether hospitals, doctors can sue over inequality in reimbursement rates.

The reasons for aligning with a hospital are changing, which makes integration even more complicated.

What do Amazon founder Jeff Bezos and the Regence Blues have in common? A new subscription-based clinic network with a simple recipe for the Triple Aim and competition for the establishment.

Creating "members for life" is the ultimate goal of any payer's customer loyalty effort. Competitive rates are one strategy to enhance loyalty, but in today's landscape of consumers who expect more engaging and cost-effective care, the proof is often in better health.

The nation's largest insurer could be shut out from the largest state insurance exchange, as regulators pursuing an active purchaser strategy try to nurture a loyal group of underwriters for the long-term.