Healthcare Finance Staff

The breakthrough hepatitis drug Sovaldi has sparked a vigorous debate about the financial sustainability of U.S. healthcare and the role of government in regulating prices.

A challenge to a Blue Cross company's recoupment practices has ended in victory for a group of chiropractors and with a favorable precedent for providers who want to appeal the decisions of certain health plans.

In an era of increasing consolidation, some insurers are taking a slightly different route on the health reform journey.

Consumer concerns about new health plan networks continue, with two new members suing over a preferred provider network they say was deceitfully marketed.

As a payer and provider and the country's largest managed care organization with a lot of digital and online patient data, Kaiser Permanente has tried to address privacy and security head-on, and may pave a way for others.

As part of a contract extension with Tenet Healthcare, Cigna has established a first of its kind quality-based reimbursement agreement.

The corporate saga of a Medicaid managed care fraud case is coming to a close as three former executives head to federal prison, offering a cautionary tale for public benefits contracting.

Just in time for plan application and premium rating season, federal regulators have finalized market policies for the ACA's second open enrollment period, while continuing the tradition of leaving a few important issues to-be-determined.

A media specialist who shares roots with Affordable Care Act foes is taking the communications helm of AHIP, tasked with defending an industry in transition and often under scrutiny for narrow networks and premium affordability.

In a changing healthcare economy, commercial payers have to re-evaluate how they do business with hospitals in order to contain costs while also meeting the demands of their members, many of whom are seeking expensive surgeries such as knee and hip replacements.