Reimbursement

With the evolving Affordable Care Act reforms and widespread digitization of healthcare data, payers are likely to make significant investments in analytics and business intelligence.

A takeover of the company would likely be the largest health insurance acquisition since the $20 billion merger of Anthem and WellPoint in 2003.

When Wall Street's biggest M&A dealmaker is hired, it would seem that a takeover is in the making, or at least a possibility being mulled.

Inspired by the links between activity, meditation and wellbeing, the country's largest mutual insurer is sponsoring an app to help its members and the public take on stress.

Beyond letting providers assume more risk and savings from it, health insurers can put them one step closer to the aim of better care, improved outcomes and lower costs.

Imagine an altogether different kind of utilization management that both payers and providers appreciate, where approvals are made at the point of decision, not after the fact. Utilization management as we know it is flawed. But keeping some semblance of the old model is necessary and a smart way to move forward.

Blue Shield of California is in the position of trying to keep its state tax exemption, while also defending its public image and defining its future mission to customers.

Can the federal government subsidize private health insurance without regulating it?

How much overhead in private and government insurance will it take to have universal coverage under the ACA? Quite a bit in one current view of the data.

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped.