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Under construction: Risk-based reimbursement

Under construction: Risk-based reimbursement

By Dave Barkholz  |  June 18, 2016

The CMS says it's well on its way to dragging hospital systems into the brave new world of risk-based contracting. The systems say, not really.

New Indiana Medicaid contracts snub UnitedHealthcare

New Indiana Medicaid contracts snub UnitedHealthcare

By Bob Herman  |  June 18, 2016

Indiana awarded new managed Medicaid contracts to four out of five bidding private health insurers. UnitedHealthcare was the lone company to miss the cut because its proposed costs were too high.

UnitedHealth Group turns to Optum for next CFO

UnitedHealth Group turns to Optum for next CFO

By Bob Herman  |  June 10, 2016

UnitedHealth Group has appointed John Rex, the CFO of UnitedHealth's Optum unit, as its next CFO. The move shows how Optum, whose services include a growing PBM and data analytics consulting, has risen to a level of importance that competes with UnitedHealth's traditional health insurance division.

UnitedHealthcare leaving Illinois ACA exchange

UnitedHealthcare leaving Illinois ACA exchange

By Kristen Schorsch, Crain's Chicago Business  |  May 31, 2016

UnitedHealthcare, the largest health insurer in the nation, will not sell Affordable Care Act plans to Illinois consumers come fall.

N.Y. Obamacare insurers ask for big rate hikes

By Jonathan LaMantia, Crain's New York Business  |  May 19, 2016

New York insurers asked for large premium increases as a way to counteract rising costs, and in some cases, gargantuan losses. Insurers selling plans to individuals requested a 17.3% average increase and those selling small-group plans asked for an average 12% rate hike.

Medicaid's unmanaged managed care

By Bob Herman  |  April 30, 2016

A new federal rule will encourage states to ramp up auditing of Medicaid managed-care insurers, many of which keep their medical spending hidden from public view.

UnitedHealth can invite customers to follow them off the exchanges

UnitedHealth can invite customers to follow them off the exchanges

By Virgil Dickson  |  April 26, 2016

Insurers that pull out of the Affordable Care Act marketplaces can nudge enrollees to follow them but can't automatically sign them up for off-exchange plans. The CMS issued guidance on the matter just days after UnitedHealth Group said it plans to ditch the exchanges in most states.

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