Health Care Delivery

An analysis of provider networks offered in the Affordable Care Act's marketplaces found large variation of the prevalence narrow networks among the states, according to researchers at the University of Pennsylvania.

The results for 2014, which was Year 3 of the program, revealed winners and losers and showed that ACOs may not be the only solution to hold down the cost of healthcare.

The deadly nature of colorectal cancer merited attention in the Affordable Care Act, which called for eliminating cost-sharing for screening to prevent deaths. The future of colorectal screening, its cost-effectiveness, and a possible way to limit unneeded tests are the topic of a recent series of papers in The American Journal of Managed Care.

Republican presidential hopefuls may all be ready to repeal and replace the Affordable Care Act, but new reports in August found the health law continues to make big changes to the US healthcare system.

Self-funded employee health benefits are becoming increasingly prevalent as employers seek ways to reduce healthcare expenses, increase plan flexibility, manage risk, and tailor plans to what their workers really want and need.

Governor Asa Hutchinson seeks changes to Arkansas' first-of-its-kind Medicaid expansion waiver, which may include workforce training requirements and higher out-of-pocket costs for those newly insured.

An analysis of data available on HealthCare.gov and 12 state-based exchanges while consumers shopped for plans found that sites should take more steps to better support consumers in making informed health plan decisions.

Alaska Governor Bill Walker (I) announced in July that he would expand Medicaid in his state despite the legislature's decision to block his efforts, and now the Republican-controlled body is suing him.

Since the first open enrollment period under the Affordable Care Act, enrollment in Medicaid has increased 21% and the program needs to be reinvented to keep up with future healthcare needs.

Enrollees on the public health insurance exchanges have shown themselves to be savvy, informed consumers, according to the results from the 2015 Survey of US Health Care Consumers report from the Deloitte Center for Health Solutions.

Millions of exchange plan enrollees are missing out on subsidies available under the Affordable Care Act because they picked a non-qualifying health plan.

As California reduced the number of adults ages 19 to 64 years without health insurance by 15.5% from 2013 to 2014, Medi-Cal enrollment among the same age group rose from 12.9% to 19.2% during the same time period, according to new data from the UCLA Center for Health Policy Research.

Many proposals to modify the Affordable Care Act include eliminating the individual mandate, which remains unpopular, but doing so would have significant effects, according to a RAND analysis.

Close to 1 million new consumers selected a plan through HealthCare.gov because they qualified for a special enrollment period, according to a report from CMS.

A report from the Government Accountability Office has found that a program for hospitals serving poor and uninsured patients has created perverse incentives to prescribe more drugs and more expensive drugs, particularly in the area of cancer care.

The recent mergers between healthcare payers continue the trend of consolidation that has swept the healthcare industry since passage of the ACA.

More employers are requiring prior authorization and the use of select specialty pharmacies for high-cost drugs.

Although the Affordable Care Act has helped many uninsured Americans receive coverage over the last couple years, the health law is essentially underfunded by approximately $500 billion.

The Pregnancy Discrimination Act of 1978 prevents questions about status from being asked, and does not require a woman to disclose her pregnancy in an interview.

Medicare and Medicaid billing fraud scams-upcoding and unbundling schemes, double and triple billing, phantom billing and illegal kickback schemes -cost the United States an estimated $100 billion annually, inflating the size of government, escalating healthcare costs and burdening taxpayers.

A Gallup survey found that only Texas still has 20% of adults who lack insurance. In 2013, 14 states had uninsured rates above 20%.

States that are unable to accelerate their efforts to slow Medicaid spending will face long-term budget imbalances, according to a new report from Fitch Ratings.

For many US community cancer centers, keeping the doors open has often meant making the difficult decision to consolidate with hospitals and large hospital systems. Site neutrality is a critical step in the journey toward better healthcare for all Americans and a healthy future for Medicare.

Donald Trump's call to "get rid of the artificial lines" references a discussion about the optional federal insurance charter, which has been going on in business circles for more than 15 years.

Households that received financial help for health insurance under the Affordable Care Act are now having tax return issues, which could jeopardize their eligibility for subsidies next year.