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Providers fear insurance mergers will intensify rate pressures

Providers fear insurance mergers will intensify rate pressures

By Bob Herman  |  June 27, 2015

The health insurance industry is on the verge of large-scale consolidation as its leaders seek to drive down costs, increase negotiating leverage and boost profits. But that could spur more consolidation among providers to counter the greater bargaining power of a smaller number of big insurers.

Blog: UnitedHealth dumps AHIP

Blog: UnitedHealth dumps AHIP

By Bob Herman  |  June 23, 2015

America's Health Insurance Plans lost its star leader a few weeks ago, and now a heavyweight member is heading out, too.

States and insurers need time, money to cement mental-health parity rules

By Virgil Dickson  |  June 12, 2015

States and major insurance companies say they need more time to implement new rules meant to offer better coverage of mental-health and substance-abuse treatment to those in Medicaid managed-care plans. The implications are huge for a population that struggles to get care, especially for...

Competition's self-destructive side

Competition's self-destructive side

By Harris Meyer  |  June 06, 2015

Gotcha. That seems to be the game healthcare providers and insurers are playing with consumers when it comes to surprise out-of-network bills. But it's not a promising business strategy. And it threatens to undermine support for the healthcare system's emerging consumer-choice/narrow-network model.

Insurers want big rate hikes, but caveats abound

By Bob Herman  |  June 02, 2015

Many health insurers have asked insurance regulators for sizable premium increases next year, but final rates are likely to be much lower than the ones requested.

New Medicaid medical-loss ratio won't strip insurer profits

By Bob Herman  |  May 27, 2015

The federal government is loosely capping the profits of Medicaid managed-care insurers. But many large companies already live within the proposed ratio, raising questions about the regulation's influence.

ASCO proposes reformed pay model for cancer care

By Sabriya Rice  |  May 23, 2015

Oncologists have proposed a new payment model for cancer care using consolidated billing codes, bundled payments and care-management fees, which they hope will improve quality of care and reduce costs.

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