Healthcare Finance Staff

Changes in open enrollments to come and evolving state and federal policies promise new uncertainties for insurers trying to soundly price their plans and retain membership.

You're sitting on too much money and have to spend it in the community, says one insurance commissioner, while another state regulator has different, minimum requirements.

In the year and years ahead for Medicaid, change will be driven as much by states as Washington, and managed care companies may have as many opportunities as challenges.

Though 2014 saw far fewer issues with Healthcare.gov, the federal government's health insurance exchange, officials are betting big that one of the industry's top firms can fix and improve the service for good.

Public hospitals can be among the most aggressive in collecting debts from poor patients, not only garnishing their wages, but cleaning out their bank accounts.

Wrangell Medical Center, a critical access hospital and long-term care facility, is on the edge of financial collapse, an independent audit by Anchorage, Alaska-based BDO USA found. A failed attempt to build a new hospital drained the hospital’s coffers of $3.5 million.

After a debut of health insurance marketplaces that fit all of the worst government contracting stereotypes, CMS has found a lead contractor to try to improve exchanges into the next decade.

Will any of the new federally-backed cooperative insurers survive? To pro-business advocates skeptical of the Affordable Care Act in general, they are doomed and should be.

Many insurers are adopting comprehensive telehealth coverage, setting the ball rolling for others to follow suit.

Of all the new cooperative insurers, the one led by a Blue Cross veteran attracting droves of exchange and employer members might seem the least likely to fail. Now the success of every co-op will be in question.