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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.

The striking variation of commercial healthcare prices

By Bob Herman  |  April 27, 2016

One of the most comprehensive, independent studies of commercial healthcare prices shows that employers and insurers that provide private health coverage pay a lot more for services depending on the state where people live.

Racial health gap narrows but disparities remain significant

By Steven Ross Johnson  |  April 27, 2016

The latest annual report card on the nation's health shows there's been progress in narrowing the gap in health disparities between blacks and whites, while Hispanics continued to have better outcomes than both.

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.

85% medical-loss ratio in final managed Medicaid rule

By Virgil Dickson and Bob Herman  |  April 25, 2016

The CMS has finalized a long-awaited rule that will overhaul managed Medicaid, which has not been updated in a decade. The medical-loss ratios were capped at 85%, and network adequacy issues have been punted to states.

15 Top Health Systems cultivate a culture of transparency

15 Top Health Systems cultivate a culture of transparency

By Maria Castellucci  |  April 23, 2016

Fostering a culture of transparency on performance measures is one of the key strategies used by the health systems that made this year's list of Truven Health Analytics' 15 Top Health Systems.

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