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Changes loom as most-popular Medigap plans face extinction

By Bob Herman  |  June 25, 2016

A provision within the new Medicare physician payment law eliminates the most popular types of Medigap plans and therefore will lead to future Medigap enrollees paying more out of pocket for their medical care.

Q&A: 'Being smart and cautious is the right way to go'

Q&A: 'Being smart and cautious is the right way to go'

By Modern Healthcare  |  June 11, 2016

Providence Health & Services CEO Dr. Rod Hochman discusses his aggressive population health management strategy for his 34-hospital system and Providence's proposed merger with St. Joseph Health System, which would have major implications for the competitive landscape in the Los Angeles basin.

Innovations: Evolent helps with high-risk patients

Innovations: Evolent helps with high-risk patients

By Beth Kutscher  |  May 28, 2016

Evolent's technology and consulting platform can help identify high-risk patients by analyzing data from multiple sources and then create physician-driven care-management plans.

Here's what CEOs think of candidates' healthcare ideas

Here's what CEOs think of candidates' healthcare ideas

By Shannon Muchmore  |  May 21, 2016

The nation's top healthcare leaders overwhelmingly back the Affordable Care Act and support its goal of pushing providers away from fee-for-service medicine and toward delivering value-based care, according to Modern Healthcare's second-quarter CEO Power Panel poll.

Commercial insurance margins offset rising Medicare losses

Commercial insurance margins offset rising Medicare losses

By Dave Barkholz  |  May 07, 2016

As hospital margins on traditional fee-for-service Medicare patients plunged deeper into the red, cost-cutting at hospitals has allowed many to make up those losses from their commercially insured clientele.

Humana dogged by Medicare, ACA pressures

Humana dogged by Medicare, ACA pressures

By Bob Herman  |  May 04, 2016

Humana may exit some individual exchange states in an effort to stop losses tied to the new Affordable Care Act policies, the insurer said Wednesday. Humana also continues to reel after losing a large Medicare Advantage employer account.

Will Medicare's physician payment overhaul drive more docs to hospitals?

Will Medicare's physician payment overhaul drive more docs to hospitals?

By Beth Kutscher and Adam Rubenfire  |  April 27, 2016

The CMS has started to answer the many questions surrounding how physicians will get paid under the Medicare Access and CHIP Reauthorization Act. But some stakeholders were immediately dissatisfied with what they saw, and the 963-page rule may have raised as many questions as it answered.

Editorial: CMS' bold gamble on primary care

Editorial: CMS' bold gamble on primary care

By Merrill Goozner  |  April 16, 2016

The skeptics were out in force last week when the CMS launched a major expansion of its comprehensive primary-care initiative. They are way off base.

Final Medicare Advantage rate policies a mixed bag for insurers

By Bob Herman  |  April 07, 2016

Did the Obama administration indulge health insurance companies with friendly changes to Medicare Advantage rate policies for 2017? Or did CMS officials stick to their guns on proposals the industry aggressively lobbied to kill? Experts say it was a little of both.

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