Reimbursement

Under the Affordable Care Act, state agencies largely retain the right to regulate premiums in their states, but so far only a handful have finalized premiums for the coming year, for which enrollment begins in November.

Amid a planned acquisition by Aetna, Humana is still going forward with new models, including an expanded deal with one of several promising primary care ventures.

At the top end, the highest median amount paid for the procedure is $61,231 in the Sacramento, California metropolitan area. On the other hand, the Birmingham, Alabama region books the lowest cost paid at $15,494.

Primary care incentives for ACOs may not be strong enough to accomplish the goals of improving patient experiences, population health and high costs.

With a progressive CEO and culture and a huge merger in the works, Aetna is promising to help reinvent healthcare. Yet it is still up against the long-term unknowns about what will constitute truly sustainable healthcare.

Even though most people now take some steps to communicate their end-of-life wishes, many may still receive more intensive care than they would have wished.

There's good news and bad news in this forecast by Avalere Health of average premium increases in 2016 for health plans sold on ACA exchanges.

Far from being overtaken by a provider-led managed care movement, Molina is getting into the game.

The Portland-based company is making one of the most audacious forays into healthcare based on a vision of highly personalized, and tech-centered patient-centered healthcare.

Sallyann Johnson considers herself a pretty savvy healthcare consumer. When she fell and injured her hands and wrists, she didn't head for an expensive emergency room, choosing an urgent care clinic near her Milwaukee home instead.