Reimbursement

In the war for affordably treating the hepatis C liver virus, pharmacy benefits managers are fighting back now that alternatives are becoming available.

As the second largest health insurer formerly known as WellPoint nurtures the new corporate Anthem brand, it's also continuing to grow its presence in the government-funded health plan space.

Deep inside the massive 2015 federal budget are provisions that could rattle the insurance industry as a whole, while also benefiting a few.

Despite failing to win rate rejection authority from voters in November, one insurance commissioner is trying to protect the market by other means, calling out carriers for what are deemed to be "unreasonable" rate increases.

To move beyond the marketing buzz of "population health" and, in some places, to avoid being usurped by provider-sponsored plans, insurers need to see provider contracting more as a partnership for a community's healthcare and wellness.

Another health insurer is investing in a digital differentiator, offering members access to telehealth and choices in using it.

Yes, Medicare Advantage is finally catching up to the rest of the health care industry, and we are now permitted to offer enrollees Rewards and Incentives.

The state that was supposed to pioneer single payer healthcare for the nation is dropping the idea. Gov. Peter Shumlin said the comprehensive tax scheme needed to raise more than $2 billion annually would be too disruptive.

In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries.

There is little doubt that the perfect storm is here. A combination of regulatory requirements, changing employer attitudes and consumer buying habits has hit hard, and health insurers are taking the appropriate steps to ensure that they don't become the next Andrea Gail. For many health plans, 2015 will be the year of technology.