News

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.

Medicare regulators are updating hospital outpatient and ambulatory surgery center payments for next year, and also outlining a potential remedy to private Medicare overpayments.

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

A new study says there's no need to worry about hospitals using their new electronic medical records to generate bigger bills and boost their income, but the study may not be checking the right data.

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.

The growth of total U.S. medical costs is slowing down, but one segment is expanding fast: prescription drug costs.

With spending on diagnostics alone for cardiovascular disease likely to be a major challenge for insurers amid the baby boom wave, Aetna is turning to an emerging option as part of a strategy to avoid invasive tests and treatments.