Healthcare Finance Staff

A few months after opening its own primary care clinics, Walmart is expanding its insurance sales program, in what could be another step toward underwriting.

In the many quests for sound Medicaid reimbursement, healthcare provider advocates may soon have another tool to compel state governments.

Health plans, providers and legislators need to increase the number of primary care practitioners participating in Medicaid as the wait for many to access care is inadequate and getting worse as enrollment mushrooms.

Drug benefits stand as some of the most consequential consumer confusions that can arise in public exchanges, increasing the onus on insurers to improve the design and explanation of formularies.

CVS recently made the bold move of quitting tobacco as part of its retail health ambitions. Now, a chief rival is upping the bet, trying to target consumer incentives and enter a wellness market in flux.

Another health system is taking a step into insurance with Medicare Advantage, banking on seniors wanting access to a prestigious brand.

More and more insurers are getting on to the smartphone and mobile health wave, trying to both attract tech-savvy members and try out new wellness ideas.

Here's a tangled web: It appears that some of the federal government's profit-loss payments to insurers are at once obligated and prohibited.

United Healthcare's shopping spree continues, as it acquires a Texas company with practice management, revenue cycle, physician referral management and other ambulatory-focused technology.

The traditional health insurance business model is on the verge of a cataclysmic shift toward individual consumers. While that will require moving away from the old IT running within many payers, it also makes now a great time for reinvention, venture capitalists argue, if not the only opportunity.