Healthcare Finance Staff

Sometimes the best solution is the simplest one. That's what some payers are finding out, for instance, with a home monitoring solution that tracks activity, rather than vital signs, for seniors and their caregivers.

Many startups and companies from other industries have physicians, hospitals, insurers and medtech manufacturers in their sights, betting that they can offer better services at cheaper prices for dissatisfied consumers.

Stuck with exchange software too flawed to fix, Maryland Health Connection leaders are choosing a novel solution that paves the way for other beleaguered state exchanges to seek help from their better performing peers.

The market for commercial full-risk insurance is slowly declining amid the rise of self-insurance, but a few large nationals, the Blues and some integrated care plans are still seeing healthy business.

New public insurance exchange enrollees are starting to use their prescription drug benefits, and so far their per-member costs are looking higher than in the average commercial plan.

Independence Blue Cross and DaVita HealthCare Partners are launching a new joint venture aiming to personalize, improve and ultimately reduce costs for chronic disease care in one of the country's most expensive healthcare markets.

The Centers for Medicare & Medicaid Services is easing back on some of the reductions to Medicare Advantage, although the negative impact could still be as much 3 percent for some insurers and many changes loom beyond 2015.

Competition from provider-owned health plans is increasing, with one of the country's largest national health systems scooping up an HMO in the South that could be a platform to enter other markets.

With about seven percent of all public and private health insurance claims paid incorrectly, insurers have a ways to go, beyond traditional models, if the healthcare spending crisis is to be reined in.

Patients don't fill first-time prescriptions nearly one-third of the time, which makes "nonadherence" an important factor working against proper disease management.