Politics and Policy

Optum, the UnitedHealthcare subsidiary appointed to fix HealthCare.gov after its troubled launch, will not rebid for a $40 billion contract.

Only 5% of Medicaid-enrolled Americans account for 50% of total Medicaid spending, and the top 1% account for almost 25% of spending, according to a new study from the Government Accountability Office.

Two new polls show majority support for the Affordable Care Act (ACA) including the health insurance tax subsidies now under review by the Supreme Court.

Even though cancer screenings have become more available because of the Affordable Care Act, the percentage of adults getting certain cancer screenings has not increased significantly since 2010.

The Affordable Care Act has led to community-based approaches for super utlilizers like health homes that appear to be making inroads.

Consensus is building on the promise of genetic testing and other technological advances to help individualize testing, prevention and treatment for better outcomes.

Misreporting of data to the Centers for Medicare and Medicaid Services exposes MCOs to civil litigation and administrative penalties.

The number of deaths from prescription pain relievers dropped 5% in 2012, and new tools are helping in the fight against opioid abuse.

The revocation of Blue Shield of California's tax-exempt status raises the question of whether for-profits have a competitive advantage.

An ongoing challenge particular to plans serving duals is a gap between the plans’ reimbursement rates and the health status of the populations they serve.

Blue Cross and Blue Shield will launch a health insurance exchange this summer that will support employers’ efforts to help retirees transition from group health benefits to individual Medicare coverage that starts Jan. 1, 2016.

L.A Care Health Plan is filling a void in California for unbanked consumers who need to maintain mandated health insurance coverage but have no credit or debit account.

Data, quality, specialty drug costs and social determinants of health are the pain points that are keeping executives at nonprofit safety net health plans up at night.

People in states that expanded Medicaid under the Affordable Care Act are far more likely to be newly identified with diabetes than in non-expansion states, according to a study published online in Diabetes Care.

The oral arguments in King v. Burwell will determine the viability of a central mechanism of the ACA-tax credit subsidies for economically-eligible citizens.

After the first year of Medicaid expansion under the Affordable Care Act (ACA), some healthcare providers and plans on the front lines are confronting operational-as well as political-challenges.

After several years of uneven progress, the pace of healthcare payment reform shifted into high gear in January when the U.S Department of Health and Human Services (HHS) announced plans to tie 30% of traditional, or fee-for-service, Medicare payments to quality or value alternative payment models by the end of 2016, and 50% by the end of 2018.

The overwhelming majority of state health insurance marketplace plans are not providing required coverage for smoking cessation, according to a new report from the American Lung Association.

There might be a reprieve if the Supreme Court overturns the ACA's tax subsidies offered on federally-facilitated exchanges.

The Affordable Care Act’s medical loss ratio provision yielded more than $5 billion in benefits to consumers from 2011 through 2013, either through the rebates that insurance companies have paid to them or through reduced health plan spending on overhead, according to a new Commonwealth Fund report.

Half of all consumers who received advance tax credit subsidies for health insurance in 2014 would have to pay back a portion of them to the Internal Revenue Service (IRS), according to a new analysis by the Kaiser Family Foundation.

A majority of Americans have compared prices before getting care and most want to do so, but access is still a barrier.

Many employers that offer generous health insurance packages are not looking forward to 2018, when the so-called Cadillac tax will impose a 40% penalty on high-cost health plans.

Provisions of the Affordable Care Act will cost $142 billion less over the 2016–2025 period than originally estimated by government agencies, due to slower premium growth and changes in enrollment sources.

A nationwide interoperability roadmap released by the U.S. Department of Health and Human Services in January outlines a set of critical actions healthcare players need to take between now and 2024 to get to a fax machine-free future.