Healthcare Finance Staff

Among the many challenges in year two of federal exchanges, the process of auto re-enrollment is bringing the potential of convenience and disruption, for both consumers and insurers.

As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.

Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.

Insurers trying to ride the wave of private exchanges need to be careful not to get swept up or knocked overboard amid varying business models and high customer expectations.

Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.

With new incentives, hospitals are increasingly making the reduction of complications, infections and readmissions a priority, but there are still infrastructure gaps that can tangle payer-provider collaboration.

While some state exchange executives exited their exchanges amid foundering technology and low public esteem, the director of one successful state HIX has landed in the growing private exchange unit of a large national insurer.

Ahead of the next open enrollment period, federal regulators are trying to clarify rules for member non-payment and grace periods, but insurers and providers may still have lingering concerns about getting paid.

Americans across the country may be pleasantly surprised to get a small check from their health plans this summer, but insurers may need to plan better if they want avoid an administrative hassle.

The nation's largest health insurer is making its free mobile app available to everyone, in a bid to move the needle on price transparency.