Reimbursement

With more employers adopting high deductible plans for their workers, the market is opening up for supplemental benefits in some of healthcare's most expensive areas.

Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.

More than 8 million Americans selected health plans in public exchanges during the Affordable Care Act's first enrollment period. But how many of them were previously uninsured? And does it matter?

Mothballing, busted budgets and a lack of credibility are swirling in the minds of ICD-10 managers, and it's enough to make some insurers question the logic of future investments.

Cigna is hoping to sustain positive first quarter results for the rest of the year,  in part relying on expanding collaborative care initiatives, as new exchange members turn out to be surprisingly high utilizers.

New York's attorney general has fired what he hopes will be a warning shot at the industry of loan brokers and lenders targeting consumers who want to pay for elective procedures.

After the first open enrollment period, WellPoint executives are confident that public exchanges will be profitable and that they won't be bailing anybody out. Other areas, they're not so sure about, despite better than expected first quarter results.

With at least 15 percent of Americans now covered through an accountable care organization of some sort, integration seems almost inexorable. But not all is well in the land of Medicare ACOs, and in the private sector, the evolution may hit a few dead ends.

A recent analysis of the federal government's 340B drug discount program suggests that eligibility is too broad and that lawmakers need to tighten it, which may mean that hundreds of hospitals currently in the program would be booted out.

Growing more anxious about the impact of the expensive new hepatitis C drug Sovaldi and the routes states may take, Medicaid managed care organizations are looking for help.