Health Plan Business

From Health Plan Week - Health insurers are turning to utilization management for complex genetic testing, with one major insurer, Cigna Corp., releasing an update that shows positive results from a policy it implemented last September requiring counseling from a board-certified genetics specialist for people seeking coverage for genetic testing for diseases like breast and colorectal cancers. Read more

From The AIS Report on Blue Cross and Blue Shield Plans - Near the end of last year’s open-enrollment period, a man clad in neon-yellow overalls showed up at an enrollment event sponsored by Philadelphia-based Independence Blue Cross. It turns out he was a baggage handler at the airport who decided to enroll in health coverage after his shift ended. Later that day, after the next shift ended, the room was full of men in neon-yellow overalls. “We learned firsthand that word… Read more

Health Plan Business Blog

By Patrick Connole - November 4, 2014
While third-quarter 2014 earnings by the major publicly traded health insurers have come in strong, there have been some unique factors to gauge from some of the companies. Over the last few weeks, four of the big five national players — Aetna, Inc., Cigna Corp., UnitedHealth Group and WellPoint,...
By Jill Brown - October 31, 2014
Some hospitals and physicians initially fought the move toward narrow provider networks, charging that they were being unfairly excluded in favor of lower-cost — and possibly lower-quality — providers. But with the rise of accountable care organizations (ACOs), many providers are partnering with...
By Patrick Connole - October 14, 2014
Two experts in the health care space say new payment models are not going to squelch reimbursement for new technology, like medical devices used in heart surgery procedures, as some in the device industry have stated in recent weeks. Value-based payment will, however, put an emphasis on providers...

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