Reimbursement

To ease the financial burden, the California agency that governs the state's Affordable Care Act marketplace issued landmark rules recently that will limit the amount anyone enrolled in one of those plans can be charged each month for high-end medicine.

Despite looming consolidation, health plans and insurers broadly need to attract more younger workers as Baby Boomers retire and markets evolve.

There will soon be one less member company of America's health insurance trade group, a sign of the industry's evolutionary turmoil.

The country's largest state insurance exchange wants to be an active purchaser negotiating on behalf of consumer, and a data-driven convener of affordability and quality.

Speakers at the Healthcare Management Association 2015 Annual Institute warn providers to embrace models like capitation, accountable care and bundled payments.

Oregon's top health insurance regulator is taking the unusual step of encouraging higher premiums in a competitive individual market, where the lowest-cost plan may also be the most disruptive.

Taking a cue from Aetna, Ascension Health and companies beyond the healthcare industry, Tufts Health Plan is raising its minimum base wage.

Anthem is scrambling to save a $53 billion takeover of Cigna, while encountering some deep criticisms of its own future potential.

According to iVantage, these hospitals excel at managing risk, achieving high quality, outcomes and patient satisfaction while running on lower reimbursements and charges than their peers.

While the modest impact continues in 2015, there are a number of influences that the ACA may have on costs in the large employer market over the next few years.