Anthony Brino

As Blue Shield of California fights to save its state tax exemption, momentum is growing around a movement to apply the same scrutiny to nonprofit hospital systems, and maybe collect the same taxes, as for-profit systems.

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

Among the major changes proposed for Medicaid plans are new provider adequacy standards, new mandates for capitated rate setting, beneficiary protections in long-term care, forthcoming quality ratings, and an 85 percent medical cost administrative ratio.

The move could affect 3,500 UPMC employees who are at least 60 years old and have 10 years on the job.

Operating income across Pennsylvania's 35 for-profit and 135 nonprofit hospitals decreased about 5 percent in fiscal 2014 from $1.8 billion to $1.7 billion, according to new data released by the Pennsylvania Health Care Cost Containment Council.

As giants like Blue Cross Blue Shield, Aetna and Humana target smartphone access, the payers must think hard about the kind of experience they're offering patients through an app.

Children's & Women's Physicians of Westchester has 276 doctors in 57 locations throughout Connecticut, New York and New Jersey.

Depending on how much the program is reformed, it could mean the difference of hundreds of millions of dollars for the thousands of hospitals who get a drug discount.

The decline of CoOportunity Health of Iowa and Nebraska has Obamacare critics and executives at large insurers skeptical that co-ops can ever compete.

“Not all readmissions can or should be prevented; indeed, some are planned as part of sound clinical care,” AHA says.