Reimbursement
To move beyond the marketing buzz of "population health" and, in some places, to avoid being usurped by provider-sponsored plans, insurers need to see provider contracting more as a partnership for a community's healthcare and wellness.
Another health insurer is investing in a digital differentiator, offering members access to telehealth and choices in using it.
Yes, Medicare Advantage is finally catching up to the rest of the health care industry, and we are now permitted to offer enrollees Rewards and Incentives.
The state that was supposed to pioneer single payer healthcare for the nation is dropping the idea. Gov. Peter Shumlin said the comprehensive tax scheme needed to raise more than $2 billion annually would be too disruptive.
In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries.
There is little doubt that the perfect storm is here. A combination of regulatory requirements, changing employer attitudes and consumer buying habits has hit hard, and health insurers are taking the appropriate steps to ensure that they don't become the next Andrea Gail. For many health plans, 2015 will be the year of technology.
One Blue insurer will find out just how much employer appetite there is for health plans with limited but transparent networks branded as both accountable and affordable.
The land of the Green Mountains, dairy farms and maple syrup is no longer pursuing the progressive dream of a single payer healthcare system, although it may still be on the vanguard trying to regulate affordability and access.
Despite the marketing buzz carried by terms like "population health" and "integration," experts say this kind of regionalization works best with partnerships between providers and commercial payers.
There are two ways of thinking about, and therefore measuring, the rate of hospital readmissions, and they often lead to quite different results and quite different decisions on Medicare penalties.