Healthcare Finance Staff

A health plan and a health system are preparing for the rise of capitation in Medicaid with a new care management venture, as more state programs try to phase out fee-for-service.

Pressure is growing on insurers to stop using mail-order pharmacies for speciality medications, and also on benefits managers to find new ways to get lower drug prices.

Even amid delays in enforcement of the Affordable Care Act's employer mandate, tax and reporting regulations are sowing confusion among employers and putting large businesses on edge.

Two accountable care networks spanning three health systems have landed contracts with one of the country's largest private employers, in a model that could leave traditional players behind.

In the midst of the exchange evolution, insurers are taking some common but also some diverging paths when it comes to the private HIXs transforming the group market.

Amid the shift to high-deductible health plans, patients are finally getting more convenient options to pay for their health services up front.

Phrases abound for the imminent future of team healthcare. Whether it's accountable care, coordinated care, medical home, or even the uber-approach of patient-centered medical community, the underlying notion is that all caregivers practice at the top of their license to essentially put patients front-and-center.

With population health management becoming a central focus for more healthcare providers, a growing number are considering adding a chief population health officer to the executive ranks.

Healthcare companies working for publicly-funded programs have one certainty: they will be serving many more Americans getting public coverage, at the same time they will have to bring down the cost-curve.

If health insurers want to garner new members and keep them well, it may be worth looking internally, at how employees are faring and how managers make decisions.