Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state's Affordable Care Act exchange after losing nearly $300 million in the individual market in 2015. Narrow networks have become the primary cost-control tool for insurers now.
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.
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 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, the largest health insurer in the nation, will not sell Affordable Care Act plans to Illinois consumers come fall.
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.
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.
Price and utilization are the two basic components of the nation's healthcare tab, and wild differences in prices for common medical procedures appear to be driving it up.
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.
UnitedHealth Group CEO Stephen Hemsley said Tuesday the health insurance and services conglomerate will pull out of most of its Affordable Care Act marketplaces. But the company won't bail on the exchanges completely and will sell individual plans in a “handful” of states.
UnitedHealth Group has already ditched its Affordable Care Act health plans in three states, but a new analysis shows that even if the health insurance conglomerate exited all of its markets, the negative impact to competition and premium prices would be limited to confined areas.
Mary Brainerd, CEO of HealthPartners, discusses her system's foray into insurance, the challenges faced by providers that want to make similar moves and her own experience in the healthcare system as a patient with breast cancer. She spoke with Modern Healthcare reporter Bob Herman.