Anthony Brino

Managed care insurer Humana reported its earnings sank 3.5 percent in the fourth quarter 2012 from the previous year, but beat both its own and analysts' projections.

With an eye towards more integrated care delivery and a new business line, two of Atlanta's largest health systems are forming an insurance company.

Health insurance company mergers and acquisitions don't always provide incremental value according to a new report from industry consulting company Deloitte.

The Green Mountain Care Board (GMCB) recently outlined its second year of work as it helps guide the state toward a publicly financed single payer healthcare system by 2017.

The U.S. Supreme Court solidified the federal government's authority to limit Medicare reimbursement appeals with a unanimous ruling to deny the claims of a group of hospitals seeking compensation for miscalculated payments going back to the late 1980s.

If hospitals launching health plans strikes some as a sign of traditional health insurance's coming extinction, the business model so many American hospitals were built upon -- fee-for-service -- is declining too. Integrated healthcare and shared savings contracts between payers and providers are going to become the norm.

On Jan. 1 2013, 106 new accountable care organizations began participating in the Medicare shared savings program, as federal health officials try to show that new health reform programs powered in part by better IT are starting to reap financial benefits.

Medicare Advantage (MA) HMO plans may be offering more efficient care than Medicare Part A and B plans, a study published in the journal Health Affairs has found. According to researchers, MA HMO enrollees have fewer hip and knee replacements and use fewer benefits for outpatient surgeries and procedures, inpatient stays and emergency department visits.

More than half of all Medicare claims denial appeals are overturned by administrative law judges according to a recent report by the Office of Inspector General.

With Medicare enrollment and spending set to grow in the coming decades, the program needs to better spread risk and incentivize value and also needs a better statutory definition of cost-benefit considerations, researchers argue in the latest issue of the New England Journal of Medicine.