Business Strategy

Like other health insurers before it, Aetna considers selling off its PBM unit.

HealthPartners' spreading care system redesign reforms nationwide could save up to $2.4 trillion over next decade.

Aetna study shows HSAs save money for members and employers.

Women aren't making it to high levels in healthcare, so executives must review their succession plan and create an engaging culture.

Communicating a culture of wellness and a supported program for members and families can help overcome childhood obesity.

Analysts speculate Health Net will sell off businesses in key states where it's not the market leader.

For personalized therapies to be incorporated into a plan's coverage, a commercially insured enrollee would need to stay with the plan for many years, as more expensive therapies require longer member retention to break even, according to Deloitte.

Individual, or short-term insurance is on the rise as more Americans face transitions due to difficult economic times.

As more Americans postpone healthcare due to the recession, Managed care executives need to get out in front of this issue now to start thinking about ways to provide monitoring and stop-gap care for those who need it most.

FTC's August 1 enforcement of Red Flags rules to reduce identity theft requires healthcare providers to have written policies on how they will respond to the "red flags" of identity theft.

As patient dissatisfaction grows with the U.S. healthcare system, consumers are shopping for value in all healthcare service areas.

As community clinics in California struggle to meet patient needs, there's a realization that there needs to be a better balance between supply and demand.

Health plan industry is trading at a discount so rumor of Aetna acquisition of Humana may not be far off base.

WellPoint decision to sell off its PBM business is seen by experts as good, strategic move for the health insurer.

Organizations need to use levers to build financial value for health investments

After New York State Attorney General Cuomo's industry-wide investigation of allegations that insurers saddle consumers with too much out-of-pocket costs, UnitedHealth says it will develop a new, independent database. Consultants say this is emblematic of a more persistent problem: the relationship among payers, patients, and providers.

Walgreens’ launch of its employer-centric pharmacy, health and wellness program, exemplifies a move by providers of service innovating their delivery models.

Absent regulatory reform prompts Michigan Blues to make some hard business decisions while groups such as Put Michigan People First say BCBSM wasn't able to get individual insurance reform legislation passed because it failed to compromise with key stakeholders.

After scrutiny by the PID, Highmark and Independence Blue Cross called off their merger. PID argues that the union would have created an insurance monopoly in Pennsylvania. The two companies deny that the combination would not have lessened competition in the market.

MCO execs should be looking at payment changes that are win-win for the payer, consumer

Measurement tools used by state regulatory bodies evaluate MCO capitalization and investment

While numbers show less growth, the $2.2 trillion spent on healthcare is still exceptionally high

Big name insurers are getting smacked with fees and penalties for dropping the ball

ASCs are gaining in popularity due to their convenience, but acute-care hospitals are losing patients and profits.

Pharmacogenomics offer value measures to MCOs as specialty drug costs skyrocket.