Health Plan Business

From Health Plan Week - Wal-Mart Stores, Inc. on Oct. 6 unveiled a program that calls for brokers affiliated with Tranzact subsidiary DirectHealth.com to offer 2015 individual plans on and off public exchanges and Medicare plans at 2,700 of its 4,311 U.S. stores, on the phone or online. The retailer is already active in the sector, via deals with carriers like Humana Inc. and their co-branded Humana-Walmart Medicare Prescription Drug Plans (HPW 2/17/14, p. 8). But this new venture deepens its ties, and is a bid to outpace CVS Health and Walgreen Co. Read more

From Health Plan Week - Globetrotting Americans may be falling through the cracks of the Affordable Care Act, says GeoBlue, which on Sept. 30 hit the market with its new Xplorer Select plan that allows U.S. expatriates and mobile world travelers living stateside in stretches to buy coverage that fulfills the ACA’s individual mandate requirements. This new product is an example of how health plans are seeking fatter margin businesses by serving Americans living overseas… Read more

Health Plan Business Blog

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...
By Jill Brown - October 1, 2014
Today Baylor Scott & White Health celebrated its first anniversary after merging in fall 2013 by reporting quality and financial results of its accountable care organization (ACO), which it said helped to validate its claim that “the merger would create tangible benefits.” The Dallas-based...

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