Reimbursement

This year's open enrollment may be mostly over. But for 2016 and beyond, insurers should prepare for evolving regulations on everything from premium increases to drug formularies.

Voters, and the industry, may end up liking parts of both Republican and Democratic ideas. They might ask a reasonable question: Why can't we take the best from both sides?

In the farming town of Exeter, deep in California's Central Valley, Anne Roberson walks a quarter mile each day to her mailbox. Her walk and housekeeping chores are the 68-year-old's only exercise, and her weight has remained stubbornly over 200 pounds for some time.

When Pavel Poliakov's small clothing shop in a picturesque college town closed last year, he felt lucky to be able to sign up for Medicaid just as Colorado expanded the program under the new healthcare law.

The nation's largest nonprofit health system is quietly getting into the insurance game under the auspices of population health.

Proposal brings falling payments for insurers, potentially disruptive options for health systems.

Deal gives provider ability to participate in the state's health insurance exchange with its narrow network.

Department of Health and Human Services says plans lacking substantial coverage of hospital and physician services don't qualify as "minimum value" coverage.

Medicare Advantage reimbursement and regulatory changes are coming, along with new probes into risk adjustment practices that could lead to settlements and clawbacks.

The federal government is extending the exchange sign-up deadline, due to concerns about tax season confusion and subsidy mistakes for some 800,000 Americans.