All News

Horizon Blue Cross Blue Shield of New Jersey said Tuesday it won't renew any of its 2013 policies for individuals and small-business owners after the end of the year because it would be next to impossible to undo the work it has put in preparing for Obamacare.

More than 100,000 individuals selected a private insurance plan through the federal online marketplace in November, HHS announced Wednesday. That's roughly four times the enrollment total during October, when the HealthCare.gov website was largely dysfunctional. But it was far short of the levels needed to meet the Obama administration's projection of 3.3 million enrollees by Dec. 31.

In the battle to control costs and out-of-pocket expenses for consumers, it would seem logical that doctors would choose the lower-cost drug. However, a report found that when given the choice, doctors chose the more expensive eye medicine over a lower cost option, even when both prescriptions provided the same effective treatment.

The federal health care exchange is incorrectly determining that some people are eligible for Medicaid when they clearly are not, leaving them with little chance to get the subsidized insurance they are entitled to as the Dec. 23 deadline for enrollment approaches.

Competition over healthcare prices and quality is coming. Transparency and the radical redesign of health insurance benefits will be its handmaiden. Companies such as General Electric are leading the way.

States' refusal to expand their Medicaid programs could cost billions of dollars over the next 10 years, and those costs are staggering.

In a decision that could have national implications, a federal judge in Connecticut temporarily blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state.

Thousands of hospitals, large and small, are girding for cuts to their Medicare payments in 2014, as federal pay-for-performance programs aimed at boosting clinical quality, improving patient experience and preventing unnecessary hospital readmissions roll into their second year.

The downward trend in preventable hospital readmissions that began in 2012 has continued well into this year, according to data published Friday on the CMS' blog. Quality experts were impressed but had questions.

The CMS is giving providers another year to show they've met the Stage 2 criteria of the federal government's incentive program to encourage the adoption and meaningful use of electronic health records. That means the start of the next phase will be pushed back a year.

Reference prices, a health benefit strategy that requires patients to pay costs above a set price, may save employers and patients money, but their potential may be limited-perhaps even more so under the Patient Protection and Affordable Care Act.

As policymakers start designing the third phase of Meaningful Use, eight healthcare and IT groups are asking the ONC's Health IT Policy Committee to commit to including patient-generated health data in the requirements.

The Affordable Care Act has dramatically increased the cost of buying a health insurance plan on the individual market in California, Texas, Florida, New York, Illinois, Georgia, and North Carolina, states that account for more than half of America's uninsured adults.

The transition from volume- to value-based care seems like common sense, yet, there are conflicting opinions regarding what this transition could mean for emergency care, and what measures will truly change practitioner behavior.

A bicameral effort is quickly gaining traction in an effort that would forever change the sustainable growth rate (SGR) and Medicare reimbursement model.

Palliative care adapted to specific high-risk patients' needs can reduce emergency room visits, improve overall care and drive down healthcare costs, but the current policy and practice framework presents numerous obstacles to its implementation.

About 29,000 people successfully navigated HealthCare.gov and selected an insurance plan on Sunday and Monday, more than the entire number of people who were able to enroll through the federal exchange during the month of October, according to a person familiar with the project.

Medicare has agreed to allow specialist medical societies to determine the quality measures physicians will report when the new reporting system goes into effect on Jan. 1.

The individual mandate of the Affordable Care Act was intended to incentivize uninsured Americans into purchasing health insurance on the exchanges. However, latest findings show that the penalty may not be enough.

In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say.

President Obama leaves the White House on Wednesday for one of the capital's most struggling neighborhoods to talk about the economy, not simply to divert attention from his troubled Affordable Care Act but to explain how that law, for all of its flaws, fits into his vision for Americans' economic security and upward mobility.

By all accounts, the shopping experience on HealthCare.gov has improved significantly. That means customers can routinely access information about what health plans and subsidies are available and select the product of their choice.

Reigning in costs is a key component of healthcare reform. So it is clear why it will be essential for both providers and policy makers to identify those most at risk for driving up costs.

Like half the states, South Carolina chose not to expand Medicaid under the federal health law next year, citing the program's high costs and inefficiency.

Much of the healthcare spotlight has been squarely focused on the federal and state implementation of the Affordable Care Act (ACA). Yet, there is another fundamental shift in policy that is occurring at the private level that will change the way health insurance is offered to consumers.

Research on how tools impact health, costs is 'inconclusive,' but clinicians say better-informed patients avoid unnecessary care, frustration

Limited provider network options in the healthcare insurance exchange are causing concern that is not unlike the backlash managed care organizations received in the 1990s.

Officials in at least a half dozen states are pushing back against health plans in the new insurance markets that limit choice of doctors and hospitals in a bid to control medical costs.

Almost 80 million people with employer health plans could find their coverage canceled because they are not compliant with ObamaCare, several experts predicted.

As the CMS begins the second year of a penalty program for preventable hospital readmissions required by the healthcare reform law, new research indicates that hospitals fare better when they focus on patient care more generally rather than targeting specific conditions, such heart failure, or specific timeframes, such as 30 days post-discharge.