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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.

Aetna loses membership in Q1 but builds revenue

By Bob Herman  |  April 28, 2016

Aetna's total medical membership fell by almost a half million people since the start of the year, but the Hartford, Conn.-based health insurer was still able to build revenue.

'Turnaround was job one. Now we are moving forward'

'Turnaround was job one. Now we are moving forward'

By Modern Healthcare  |  April 09, 2016

Last fall, Karen Ignagni took over as CEO of EmblemHealth—a financially troubled New York insurer with 3.2 million covered lives—after 22 years at the helm of America's Health Insurance Plans. She recently discussed the challenges she faces in her new position.

Rheumatoid arthritis drug prices on the rise

By Adam Rubenfire  |  April 01, 2016

Rheumatoid arthritis drug prices have skyrocketed over the past three years, despite little to no change in composition, experts and insurers say.

Editorial: Keep CMS' value-based pay off my Medicare drugs!

Editorial: Keep CMS' value-based pay off my Medicare drugs!

By Merrill Goozner  |  March 12, 2016

Everyone is in favor of value-based reimbursement in healthcare, right? If you're still wearing those rose-colored glasses, take a closer look at last week's reaction to Medicare's proposal to test new ways of paying for drugs administered in physician offices and hospital outpatient departments.

Michigan's hospitals post impressive profit margins

By Jay Greene, Crain's Detroit Business  |  March 10, 2016

Michigan's 83 acute-care hospitals posted higher total profit margins in 2014 than in 2013, averaging 8.2%, but health plans' profits dipped slightly to 0.9%, according to the 2015 Michigan Health Market Review.

Blog: Former Caesar's Casino CEO places bets on patient loyalty

Blog: Former Caesar's Casino CEO places bets on patient loyalty

By Joseph Conn  |  March 01, 2016

Hospital CIOs meeting in Las Vegas got comps from a former gambling casino executive. But they weren't chips, free rooms or limousine rides. It was something potentially more valuable. They were told how to use data analytics to attract loyal healthcare customers who are increasingly choosing...

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