Healthcare Finance Staff

Just as government marketplaces are transforming their individual policy businesses, Blue Cross and Blue Shield companies are setting up private exchanges to save a far larger source of traditional revenue.

Insurer premiums in the second year of public exchanges look financially wise to credit experts, although there are also some double-edged swords.

Even before federal approval is won for the experimental program, insurers in one large state are ready to start selling exchange plans to Medicaid beneficiaries.

After the botched rollout of insurance exchanges last year, the federal government is trying to get the technology right for what promises to be just as big a consumer turnout this fall.

A new start-up is hoping to become the largest enabler of primary care in the country within six years, by letting independent docs start ACO networks and stay free of the hassle of hospital systems and payers.

Aetna is extending its ACO network and health plan offerings in America's heartland, trying to meet promises of bringing accountable care to the commercially-insured masses in competition with United and WellPoint.

Any day now, the Supreme Court will issue its decision on the "contraception mandate" and could add more complexity to health plan administration, while another dispute may spell even more trouble.

Insurers that have submitted applications to sell exchange plans are currently waiting, hoping regulators will approve their premiums and that consumers will find them affordable, in what will be a more crowded marketplace.

The state of Illinois is nailing down key Medicaid policies ahead of a massive managed care rollout and accountable care experiment.

WellPoint has won the right to challenge a hospital's chargemaster billing practices, but the ultimate resolution could still disrupt relations with a key provider in a large market.