Reimbursement

Medicaid-focused managed care company Centene is adding to its portfolio a data-drive health engagement platform, a sign of the increasing interest in wellness for both commercial and publicly-insured populations.

Amid a fractious public dispute with its chief rival, Highmark and its health system are making a community investment that, though unlikely to turn a profit, may reap returns in loyalty and reputation.

Competition for treating America's hepatitis C population is intensifying among pharmaceutical companies and benefits management firms, suggesting a thaw in the $1,000 per-pill price of last year's blockbuster.

Managed care organization Health Net Inc. said this week that it has formed an accountable care organization with John Muir Health, bringing together a network of medical centers and physicians to cover three counties in California.

While prices have increased everywhere, the rate of increase was much lower at hospitals in states using the site.

The Centers for Medicare and Medicare Services has extended the contract with four private companies it previously hired to track down, remedy and often recover improper Medicare payments.

The regulator of the nation's largest state market is taking a proactive, interventionist stance on the still fractious issue of network adequacy.

In the fourth quarter of the Obama Administration, the nation's chief trade regulators are promising a healthy dose of scrutiny for the continuing waves of healthcare provider mergers and acquisitions.

For 25 years I've been saying that I wished a little state like Vermont would implement a single-payer Canadian-style health insurance system -- "Medicare For All." I have always thought that this debate will never be settled until a state gives it a shot and everybody witnesses the result.

One of the Midwest's largest Blues is winning in the new insurance market under the Affordable Care Act, without yet selling a public exchange plan.