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Utah Medicaid expansion hits dead end

By Associated Press  |  February 26, 2015

Utah Gov. Gary Herbert's trimmed-down plan for expanding Medicaid appears to have hit a dead end at the state Capitol.

Hospital prices drop for the first time

By Melanie Evans  |  February 21, 2015

Payers' efforts to drive down hospital prices may be succeeding. Prices that private and public health insurers paid to acute-care hospitals declined in January, compared with the same month a year ago, the first time they have dropped since the federal government began collecting these data.

CMS: Boost Medicare Advantage payments 1.1%

By Bob Herman  |  February 21, 2015

The CMS has proposed increasing health insurers' Medicare Advantage payment rates by 1.05% for 2016, a move that kicks off a 45-day dogfight in Washington before the rates are cemented.

Value-based care not likely to end payer/provider financial spats

By Bob Herman  |  January 22, 2015

A large payer and health system in California are embroiled in a bitter feud over expired contract terms, the type of fight all too common in the fee-for-service world. Value-based pay promises to align providers and payers in the pursuit of efficient care, but they're likely to keep fighting.

Lessons from Vermont

Lessons from Vermont

By Merrill Goozner  |  January 03, 2015

Sorting through the shards of Vermont's discarded single-payer health insurance scheme reveals the plan was undone by its generosity toward patients, hospitals and physicians, not its core assumptions.

Pricey 'breakthrough' drugs confound Medicaid rate-setting

By Virgil Dickson  |  December 12, 2014

Actuaries say it's getting increasingly difficult to advise states on sound rates for Medicaid managed-care plans because high-priced specialty drugs like Sovaldi continue to hit the market at a rapid clip.

UnitedHealth's earnings suggest tame medical spending

By Bob Herman  |  October 16, 2014

UnitedHealth Group's profit per share in the third quarter exceeded Wall Street's estimates in large part because of lower-than-expected medical costs, giving hope for other health insurers that healthcare spending is still being held in check.

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