Health Plan Business

From Health Plan Week - Recent results from a UnitedHealthcare oncology-focused bundling pilot have caught the attention of the health insurance industry by demonstrating that the model saves money for more than just procedural care, like knee replacements. Read more

From Health Plan Week - Health insurers and PBMs are stepping up efforts to detect and stop the diversion and abuse of opioid pain medications like Endo Pharmaceutical Inc.’s Percocet and Purdue Pharma LP’s OxyContin through sophisticated and multi-layered analysis of claims data and monitoring. Read more

Health Plan Business Blog

By Jill Brown - September 2, 2014
An Orange County, Calif.-based children’s hospital is among the most recent providers to partner to form an accountable care organization (ACO) that will seek contracts with commercial insurers. Despite that, specialized children’s care is not a primary focus for many ACOs. Most ACOs, even...
By Patrick Connole - July 28, 2014
In talking to insurers active in the Medicare Advantage (MA) space, the theme for the 2015 plan year is “pressure,” as in the application of pressure on margins from the reduction in government reimbursement. One such carrier, Cigna Corp., spoke about the outlook for next year as it and other...
By Jill Brown - June 30, 2014
Is the U.S. Supreme Court’s decision this morning in Burwell v. Hobby Lobby Stores, Inc. the “first step toward repeal” of the Affordable Care Act (ACA), as St. Paul, Minn.-based Citizens’ Council for Health Freedom (CCHF) says? Probably not. The Supreme Court found in a 5-4 decision that closely...

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