Politics and Policy

Plans should consider adapting similar strategies from online product exchanges to prepare for 2014.

Payers, providers must design compliant policies and ensure access

While it may be impossible to prevent a data breach, anticipate vulnerabilities and implement fixes

CMS revises rates for 2014 following heated protests from Congress, beneficiaries

The 21 to 27 age group will see net costs increase $470, and that's the worst of it

10 Things You Need To Know About ICD-10:ICD-10 presents payers with an opportunity to deliver more profitable and innovative care

Federal law does not allow generic pharma companies to deviate from brand formula.

Experts expect all 50 states to be up and running on time

States contract with plans to cover expanded populations, many of which need high-cost care

Experts and economists are looking at healthcare through the lens of their own ideologies

Several Republican governors are going to expand Medicaid eligibility under PPACA

Payers struggle against market headwinds

The president’s proposal to cut Medicare drug payments sets off a firestorm.

U.S. Court of Appeals rules off-label promotional speech constitutional.

The federal government and states will face a number of challenges upon establishing and operating federally facilitated health insurance exchanges.

Utah governor hopes to gain federal certification for the state's insurance exchange, which would ideally use a hybrid exchange model.

Republican governors from Ohio and Michigan have committed to expanding Medicaid in their states.

The development and implementation of evidence-based appropriateness criteria may help reduce costs associated with an increase in elective procedures.

Insurers see higher unit costs and increased utilization while HHS examines premium hikes

The Medicaid program currently covers 60 million people, but it's about explode in terms of cost and enrollment

Healthcare reform moves forward with the re-election of President Obama.

While most states have policies to evaluate premium increases, the Rate Review Program under the Patient Protection and Affordable Care Act (PPACA) puts a brighter spotlight on states' authority.

Bonuses paid to plans for star ratings are sure to be targets for cost cuts

Surveyed readers indicate that Medicare and Medicaid will be 2013's big winners