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The pharmacy benefits industry is challenging a new state law, trying to protect a key management tool that insurers, employer groups and public payers have been relying on for cost stability.

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Signing people up for health insurance is the easy part of Rawha Abouarabi's job ministering to immigrants and Arab Americans in this manufacturing hub along the Rouge River in Dearborn, Michigan.

For a state trying to get a handle on notoriously high healthcare spending, there are some reasons to be cautiously optimistic and keep following those with the most market power.

Amid a massive backlog of hospital inpatient claims appeals at the Office of Medicare Hearings and Appeals, the Centers for Medicare & Medicaid Services is giving providers the chance to settle up and get paid - at least in large part.

A new analysis of hospital readmissions allows state Medicaid medical directors to better understand the nature and prevalence of hospital use in the Medicaid population, and provides a baseline for measuring improvement.

Forty years after the creation of a national regulatory framework for workplace benefits at large employers, employee health benefits are in the midst of another evolution.

The 340B program is critical for hospitals and other providers that serve some of our country's poorest and most vulnerable patients. When providers monitor compliance and track 340B drugs properly, the program can fulfill its intended purpose.

Another state is being offered a federal waiver to expand Medicaid on its own terms, hoping to bring the efficiency of private insurance and new value incentives to the public payer program.

Healthcare organizations are struggling to get a handle on population health and find the necessary data management tools.