A new report says that health insurance companies discriminate against people with hepatitis B and C by charging high out-of-pocket costs for drugs, but the industry lobby has called the analysis “very one-sided” and limited in scope.
The blockbuster case King v. Burwell may be over, but the U.S. Supreme Court is hardly done deciding important healthcare matters.
The CMS will release 2016 star ratings for each Medicare Advantage plan on Thursday, and experts predict more insurers will receive higher quality scores as they adapt to the government's more rigorous standards.
Cone Health joins the ranks of health systems entering the insurance business as it begins to market its new Medicare Advantage plan.
Health insurers that sold plans and lost money on the Affordable Care Act's exchanges in 2014 will receive only a portion of the $2.5 billion promised to them as safety-valve payments, a CMS official said last week.
Health information technology cognoscenti predict most large hospitals and health systems, physician groups and health plans can handle the numerous, complex and very specific new codes. Any cramps will appear later as providers' cash flows get hit by delayed reimbursements.
New York state's experiment to better coordinate care for low-income and disabled residents who are dually eligible for Medicaid and Medicare is losing hundreds of enrolled beneficiaries.
Diabetic patients are a popular target population for health systems that hope to improve patients' health with better care coordination and closer management. But new data from the research collaborative OptumLabs suggest diabetes management can be too aggressive.
The pharmacy benefit management industry has been quietly changing amid healthcare payment reforms and an increasingly fierce debate over drug prices. Now a leadership shuffle at Express Scripts has experts speculating that the days of PBMs as stand-alone companies may be numbered.
Hundreds of children in Minnesota could soon have a harder time getting healthcare because of a contract dispute between a payer and a provider.
At an investor conference last week, Aetna Chief Financial Officer Shawn Guertin said the company intends to create a health services division with Humana's assets once their $37 billion deal was closed.
Politicians and healthcare leaders don't agree on much about the root causes and problems with consolidation in the healthcare sector. More congressional hearings are likely to inflame the debate.