Healthcare Finance Staff

In California, insurers and regulators are fighting for control of the post-reform insurance market.

With federal rules governing health plan spending looking like they're here to stay, insurers are making inroads on compliance, although they will hope for possible tweaks in the future.

With the first healthcare exchange open enrollment period concluded, savvy health plan marketers are spending much of their time and resources sifting through enrollment data hoping to gaint insights. However, this is a new world for plan providers, and most current marketing plans and sales strategies were developed for commercial and Medicare sales.

As Affordable Care Act exchanges bring health plans to previously uninsured Americans, there are also market segment transitions that could prove favorable for risk pools.

Trying to help transition the American healthcare system beyond fee-for-service, Blue Cross and Blue Shield companies are starting to reach new reimbursement milestones.

UnitedHealthcare's bid to change financial incentives for oncologists has led to some promising, though somewhat mixed results.

Joining its peers in touting accountable care, Cigna has met a fairly ambitious goal set two years ago, but more time is needed to test the strategy's sustainability.

One regional insurer is using a new approach in provider network management, as it aims to tackle a laborious administrative process.

One of the country's largest health insurers is being accused of having misleading information on doctor and hospital network participation for EPO and PPO plans sold in the state exchange.

Health care providers have long expressed dissatisfaction with the time they spend coordinating care with health plans and getting paid. Indeed, one of the most inefficient and costly processes for both providers and payers is Prior Authorization.