Industry Analysis

A new RAND study uncovers significant differences between healthcare costs paid by privately insured patients and those paid out by Medicare.

Here are five key metrics that executives should pay attention to as they navigate challenges.

While the Democratic House and Democratic presidential candidates tout Medicare for All, opposing forces are also at work.

The tools and processes one of the largest not-for-profit Medicare Advantage plans uses to help seniors.

The ONC and CMS medical information transparency rule for patients, providers, and insurers may be the biggest change in healthcare system operations since the ACA. Here’s what to expect.

The combination of one of the country’s largest insurers and one of the country’s largest pharmacy chains will dramatically reshape the healthcare industry.

Managed Healthcare Executive has sorted through the platforms of the Republicans running for president to tell you where they stand on healthcare issues.

A new report looks specifically at spending on healthcare for the privately insured in the U.S in 2014. Here are the findings.

A low-fat plant-based vegan diet may help obese children lower their risk of heart disease, finds a new study from Cleveland Clinic.

Results from a national survey show that one-third of American adults use complementary medicine practices or products, including yoga, fish oils, massage therapy and ginseng.

At a time when insurers are expanding their presence on state exchanges and rolling out tech-savvy portals to capture new customers, single state “Blue” insurers are finding themselves hamstrung by regulations and lack of capital.

If 15% to 30% of HCV-infected beneficiaries receive treatment in 2015 with the cost of treatment averaging $84,000, Medicare Part D could increase between $2.9 billion and $5.8 billion

Utilize pharmacy benefit tools and member engagement strategies

ACA’s emphasis on accountable care organizations, patient-centered medical homes, readmission penalties and pricing pressures on hospitals makes it attractive for hospitals to work together to share services and increase the efficiencies

Size of the increase often relates to the percentage of market share a plan has achieved

Findings project total enrollment will eventually surpass state and federally-funded exchanges, reaching 40 million by 2018

Lowest rate achieved since 2008

72% of organizations use more than 10 electronic interfaces to collect data

The initiative would expand Medicare’s present Bundled Payments for Care Improvement (BPCI) program

Cost-sharing is not being lowered for other treatments and services, particularly specialty drugs

One in five Americans now receive their health insurance through Medicaid

The least expensive plans offered by UnitedHealthcare, Aetna, Cigna and Assurant were over 40% more expensive on average than the least expensive plans on the exchanges

Funding will help expand service hours, hire more medical providers and add oral health, behavioral health, pharmacy and vision services

Industry experts question whether the high cost of treatment is beneficial to patients and health plans

Price continues to drive prescription drug trend

Clear, actionable comes to the forefront

While patients may complain about the rising cost of their healthcare, few of them appear willing to do much about it, according to a new survey.

PBGH program gives employees no-cost joint replacement and free travel to top hospitals

Center aims to transform healthcare through collaboration on the latest in health IT.

More research into the way providers and patients respond to incentives will be important to guide healthcare policy.