Susan Morse

While losses in the Obamacare exchange markets are chasing insurance giant UnitedHealthcare away, New England insurer Harvard Pilgrim Health Care says the exchange business is a major moneymaker.

Beginning in 2019, insurance companies that contract with the exchanges must either exclude from their networks any hospital that doesn't meet the federal government's 2020 target C-section rate or explain why they aren't, according to the new contract approved by the Covered California board.

In a joint partnership, Anthem Blue Cross and Blue Shield and Aurora Health Care will form the Wisconsin Collaborative Insurance Company, the companies have announced.

In addition to payments, CMS is proposing new assessment-based quality measures, and claims-based measures for inclusion in the quality reporting program.

The Centers for Medicare and Medicaid Services for the first time has released data highlighting the racial and ethnic disparities in patient experience and clinical care measures for Medicare Advantage beneficiaries.

UnitedHealth Group is exiting the Affordable Care Act markets in Michigan, Oklahoma and other areas citing a lack of profitability.

A single, coordinated approach to performance reporting is needed to make promised Medicare payment reforms work, the American Medical Association and other physician groups are expected to tell lawmakers Tuesday morning during a Subcommittee on Health hearing on Capitol Hill.

Rule affects 3,330 acute care hospitals, 430 long-term care hospitals.

The more than 1,500 healthcare providers taking part in the Bundled Payments for Care Improvement initiative may extend their participation in Models 2, 3 and 4 through September 30, 2018, according to the Centers for Medicare and Medicaid Services.

A Chicago couple used their healthcare business to bilk Medicare out of $45 million while also conspiring to force a housekeeper to work against her will, according to an indictment returned this week in federal court in Chicago.