Reimbursement

The federal government is already pushing providers towards more risk, so it's not surprising that many are going all in by sponsoring a health plan.

In another provider-insurer collaboration, Texas Health Resources and Aetna on Thursday announced the formation of a jointly owned health plan company.

In the report issued Thursday, Blue Shield for the first time listed total compensation for its 10-highest paid executives by name. The company also offered details, such as base salary and incentive awards.

News that a CareFirst BlueCross BlueShield subsidiary will stop selling bronze level plans on the Virginia marketplace next year prompted some speculation that it could signal a developing movement by insurers to drop that level of coverage altogether. The reality may be more complicated and interesting, some experts said, based on an analysis of plan data.

Missouri state regulators on Wednesday said they will not support Aetna's proposed $37 billion takeover of Humana, according to documents filed May 24 by John M. Huff, director of the Department of Insurance, Financial Institutions and Professional Registration for the state.

The American College of Emergency Physicians is suing the Department of Health and Human Services and other federal agencies for setting payment rules that result in inadequate reimbursement for out-of-network emergency medical services, according to the civil lawsuit filed in U.S. District Court on May 12.

A shared health information platform makes for effective teamwork.

Cigna said it would tap into its experience with prevention, wellness and chronic disease management programs to will work with clients, physicians and others to develop ways to increase prevention and treatment of substance use disorders.

Sponsored by Xerox. While there is optimism around the shift, payers and providers have a long list of concerns. Where is the industry finding the most challenge now?

As margins are squeezed, interest in provider-sponsored health plans continues to increase. The expectation, according to a new PwC report, is that half of health systems will be applying or will consider applying for an insurance license.