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The striking variation of commercial healthcare prices

By Bob Herman  |  April 27, 2016

One of the most comprehensive, independent studies of commercial healthcare prices shows that employers and insurers that provide private health coverage pay a lot more for services depending on the state where people live.

What UnitedHealth's retreat says about the ACA marketplaces

What UnitedHealth's retreat says about the ACA marketplaces

By Bob Herman  |  April 23, 2016

UnitedHealth Group's decision to pull out of most of the Affordable Care Act's insurance exchanges created a big headache for the Obama administration, but the reality of the situation is a lot more nuanced than it might appear.

Data sought to measure move to value-based pay

Data sought to measure move to value-based pay

By Joseph Conn  |  April 23, 2016

The White House’s effort to quantify the nation’s progress on converting to alternative payment models is about to kick off with a gathering of heavy hitters in the healthcare industry.

Anthem, Aurora Health Care plan joint insurance venture

By Bob Herman  |  April 23, 2016

Roughly 18 months after Anthem rocked the healthcare business community with a new provider-insurance alliance in California, the insurer has formulated another similar project. Anthem and Milwaukee-based Aurora Health Care will co-own a new health insurance company.

Michael Garfield named CEO at Mercy Health Cincinnati

Michael Garfield named CEO at Mercy Health Cincinnati

By Modern Healthcare  |  April 23, 2016

Michael Garfield has been named senior VP and CEO at Mercy Health Cincinnati. He takes over for John Starcher, who last month was named incoming president and CEO for parent system Mercy Health, also in Cincinnati.

Ruling on cost-sharing subsidies could rattle insurers in midst of rate-setting

By Harris Meyer  |  April 22, 2016

Another bombshell could soon drop on the ACA insurance exchange market, and it might come at a highly vulnerable moment for Obamacare. A federal judge is expected to soon issue her ruling in a case that challenges the Obama administration's funding of the ACA's cost-sharing subsidies.

Blog: 'Measure madness' consuming healthcare resources

By Sabriya Rice  |  April 22, 2016

The volume of measures that exist, promulgated by lack of alignment and poor coordination, has created an environment of measure madness, “consuming precious resources that could be directed toward meaningful efforts to continuously enhance quality and patient safety,” according to a...

The short and chaotic life of an Obamacare darling

The short and chaotic life of an Obamacare darling

By Michael Waldholz, Crain's New York Business  |  April 18, 2016

A Crain's investigation shows how Health Republic, the insurance company that was supposed to be about people, not profits, misled its customers and ran itself into the ground.

Editorial: CMS' bold gamble on primary care

Editorial: CMS' bold gamble on primary care

By Merrill Goozner  |  April 16, 2016

The skeptics were out in force last week when the CMS launched a major expansion of its comprehensive primary-care initiative. They are way off base.

CMS unveils Primary Care Plus

CMS unveils Primary Care Plus

By Virgil Dickson  |  April 16, 2016

With less than a year to go in the Obama administration's public-private push for better care management among primary-care providers, the CMS has rolled out a souped-up care-delivery model.

States skip 'vertical choice' on SHOP exchanges because it could raise premiums

By Virgil Dickson  |  April 15, 2016

Twenty states with federally run small business health options program (SHOP) exchanges are taking the White House up on its offer to a launch more options in an effort to attract more employers to use the marketplaces. Those opting out fear it will have a negative impact on their risk pools and...

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