Healthcare Finance Staff

The currents of health reform and consumerization are getting more treacherous for incumbent hospital businesses, but payers and retailers, especially, have waves to ride.

Aetna's ACO portfolio keeps growing, as the insurer tries to capitalize on Medicare Advantage rate pressure and step in where some competitors face upheaval.

Many insurers setting premiums for the upcoming exchange season seem to be banking on consumer price sensitivity. Some are also poised to draw the most cost-conscious enrollees away from competitors.

Highmark, an insurer with its own health system, is challenging a growing and controversial billing practice that also happens to be a central part of some health system integration strategies.

The pharmacy benefits industry is challenging a new state law, trying to protect a key management tool that insurers, employer groups and public payers have been relying on for cost stability.

Signing people up for health insurance is the easy part of Rawha Abouarabi's job ministering to immigrants and Arab Americans in this manufacturing hub along the Rouge River in Dearborn, Michigan.

For a state trying to get a handle on notoriously high healthcare spending, there are some reasons to be cautiously optimistic and keep following those with the most market power.

Forty years after the creation of a national regulatory framework for workplace benefits at large employers, employee health benefits are in the midst of another evolution.

Another state is being offered a federal waiver to expand Medicaid on its own terms, hoping to bring the efficiency of private insurance and new value incentives to the public payer program.

Healthcare organizations are struggling to get a handle on population health and find the necessary data management tools.