Healthcare Finance Staff

As they try to get a better handle on population health management and member engagement, payers are increasingly looking to consumer-facing technologies for help, according to the latest report from Chilmark Research.

Hospitals and managed care organizations in Rhode Island are set to take reimbursement cuts under the governor's proposed budget -- an untenable position, some say, as Medicaid expansion brings them more patients.

Connecticut's health insurance exchange is the first to meet its enrollment projections, but officials might be hoping to attract younger Nutmeggers before the 2014 open enrollment period ends.

The first insurer to post last year's financial results, UnitedHealth Group saw revenues grow 11 percent but margins slip -- a sign of industry pressures ramping up in the new era of health reform.

After recovering claims from a pharmacy provider, a group of 27 states are suing Novartis, alleging the company participated in a kickback scheme to boost Medicaid sales for a controversial blood drug.

Empowered consumers, rapid innovation and increasing competition are among PwC's top issues for providers and payers and other healthcare businesses for 2014, the company announced last week during a webinar.

Now that most consumer-facing parts of HealthCare.gov are working, the biggest problem is "making sure plans get paid," the lead manager of insurance exchanges and regulations at the Centers for Medicare & Medicaid Services told federal lawmakers.

Aetna, Cigna and the Blues sprang out of the gate in just the first two weeks of the year with announcements of newly formed accountable care organizations and expansions of existing ones, adding more scale and breadth to testing of value-based models to deliver better care at lower cost.

Enrollment in Medicaid managed care is continuing its growth in tandem with eligibility expansion, bringing benefits and challenges to insurers, according to an Avalere Health analysis.

After requiring small businesses to buy insurance through the state exchange, continued website dysfunction has left Vermont health officials asking businesses to enroll directly with insurers.