Healthcare Finance Staff
What happens when an insurer with the bulk of a state's public exchange membership pulls out?
Before the next open enrollment begins, verification issues are lingering for several hundred thousand consumers on existing exchange plans, leaving insurers and providers facing a range of potential problems.
Narrow networks sparked consumer angst and new government oversight after the Affordable Care Act's first open enrollment period. But now, there's evidence that limited networks can be a win-win, albeit with one primary caveat.
With increasing regulatory pressure, payers are keen to adopt new technologies, improve efficiencies, implement analytics and build interoperable platforms, but are left looking for ways to access clinical data from providers and other caregivers. The challenge is often in getting a single, standard view of patient data and translating this data into actionable intelligence.
In the latest development of private health insurance exchanges, one large Blue Cross company is betting on the single-carrier model as a way to keep group business, or hopefully expand it.
A joint investment in a health IT company by two Blue Cross companies and a private equity firm is reaping a few billion amid healthcare's tech boom.
The current hospital-based system of graduate medical education does not meet the needs of modern healthcare delivery or the training of the future physician workforce, according to a new reform proposal by the American Academy of Family Physicians.
Ahead of a corporate branding change and a new open enrollment period, WellPoint is charging ahead with accountable care and population health strategies.
As proton cancer treatment centers expand, payers and providers may have to collaborate to expand the evidence base, to avoid the highly-expensive technology crowding out other investments.
Weill Cornell Physicians, Cornell University's physician group, has inked a new accountable care agreement with Aetna, intended to enhance care for approximately 9,000 of the insurer's commercial and Medicare members in New York.