Reimbursement

While many states have been challenged to expand their insured populations in ways encouraged by the Affordable Care Act, Ohio and Kentucky have leveraged their distinctive political and business climates to find early success.

Some states have found practical success in establishing the Affordable Care Act, but what distinguishes their efforts are their unique fit within each state's distinctive political and business climates.

Humana is naming a healthcare outsider as its next chief innovation officer, just as executives are looking for breakthroughs from recent acquisitions.

The Centers for Medicare & Medicaid Services' proposal to mandate broader provider networks in public insurance exchanges could have the unintended consequence of discouraging insurer participation, according to analysts at Moody's.

A new federal regulatory proposal to ensure adequate insurance networks could help not-for-profit hospitals, Moody's said in a briefing released this week.

The administration has confirmed that the individual policies that were supposed to be cancelled because of Obamacare can now remain in force another two years.

The federal government is once again extending pre-2014 health plans and outlining other tweaks and finalized rules for several key programs that regulators hope will smooth what continues to be a bumpy and confusing transition.

In case anyone was wondering, the RACs haven't gone away for good. They're just taking a vacation. The Centers for Medicare & Medicaid Services announced a "pause" in RAC audits last month, in preparation for the procurement of the next round of RAC contracts.

The parent company of some of the country's largest Blues plans appears to be shoring up cash reserves for what may one of the most unpredictable years in its history.

Benefits consulting firms that made early forays into private insurance exchanges are likely to be rewarded for their prescience, although the competition is growing.