After years of bleeding money from selling plans on the Affordable Care Act exchanges, Highmark turned a profit in that business for the first time in 2017 after hiking premiums and narrowing its networks.

The CMS released a comprehensive report showing ACA exchange enrollment for 2019 coverage. While enrollment fell in states that use HealthCare.gov, it held steady in states operating their own exchanges.

The questions about EHR compliance come a week after whistleblower allegations that Community Health Systems made false claims about its EHR technology.

Premiums are generally lower in places where multiple health insurers compete to sell plans, and now more people have three or more options compared to 2018.

Many of the largest publicly traded health insurers saw their bottom lines soar in 2018. Their CEOs' paychecks were no different.

Unlike Medicare, the VA, most Medicaid programs and most commercial insurers, UnitedHealthcare—the nation’s largest insurer—excludes urinary catheters from coverage for many commercial plans.

The two whistleblowers, who worked for CHS as recently as December 2016, allege the for-profit system received more than $450 million in EHR incentive payments between 2012 and 2015.

Dr. Patrick Conway will become CEO of Portland, Ore.-based Cambia Health Solutions in addition to maintaining his current role as CEO of Blue Cross and Blue Shield of North Carolina as part of a strategic affiliation between the two not-for-profit companies.

Dr. Craig Samitt, who took over as CEO of not-for-profit insurer Blue Cross and Blue Shield of Minnesota in July 2018, says he’s determined to transform healthcare in the state by driving value-based payment models and eliminating healthcare disparities among community members.

The CMS asked for recommendations on how to eliminate barriers to facilitate insurance sales across state lines.

A federal appeals court on Tuesday affirmed a lower-court ruling dismissing a class action against insurer Cigna Corp. for allegedly committing fraud by misleading shareholders about its compliance with Medicare regulations.

While Medicare Advantage insurers are excited about getting more flexibility to tailor supplemental benefits for chronically ill patients in 2020, they aren't happy that CMS wants to increase the use of "encounter data" to calculate their payments.

A RAND Corp. study has found that mailing a check to workers who visit lower-price providers for certain elective healthcare services is an effective, though modest, way to reduce healthcare costs.

North Carolina is among a small number of states seeking to set prices for hospital care.

Montana’s state employee health plan has saved millions in costs since shifting to a Medicare reference-based reimbursement model in 2016 to gain better control over its healthcare spending.