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.
America's Health Insurance Plans lost its star leader a few weeks ago, and now a heavyweight member is heading out, too.
Optometrists are working more closely with physicians and insurers to identify patients' chronic conditions and ensure those patients receive appropriate medical care.
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...
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.
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.
The U.S. Supreme Court case over the Affordable Care Act's subsidies will be decided in the next month, and the nation's largest health insurer remains guarded about how it thinks a ruling would affect the healthcare industry.
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.
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.
Physicians face tough predicaments in attempting to prescribe highly effective new hepatitis C drugs for their patients while health plans strive to curb the high costs of those medications.
Doctors are finding themselves in tense situations as they try to prescribe new hepatitis C drugs to patients eager for a cure while health plans limit coverage to manage the costs of the medications.
UnitedHealth Group is rolling as one of the biggest winners in the Affordable Care Act era. The health insurer and services company posted significant first-quarter gains across all of its business lines.