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The bigger obstacle to overcome will be the general lack of understanding of the healthcare system

Aging baby boomers will bring more people into Medicare, while reform will expand Medicaid

Republicans introduced a bill to abolish Medicare's Independent Payment Advisory Board (IPAB) before it even gets off the ground

For health reform to be a success, employers must continue to provide healthcare benefits

Beyond basic compliance with the regulations, the market fallout could be anything from a pin drop to a sonic boom

Navigating legal issues to create the best possible program sometimes requires a delicate balancing act by plan sponsors

The empowered patient is one change that stands above all others

Provider groups are on task to create accountable care organizations (ACOs), and many believe they will change the delivery of healthcare

Most existing benefit plans will lose their grandfathered status by 2019, according to observers

Now is the time for collaboration of payers, billers and providers to lead the industry by reducing inefficiencies

A cumulative 23% cut is scheduled for this December. Another 6.5% cut in January 2011 and a 2.9% cut in January 2012 are scheduled.

The stimulus package provided more than $1 billion in federal support for comparative effectiveness research (CER), which has the potential to improve clinical decision making

The significant challenges facing insurers include minimizing disruption and mitigating the impact on cost

It will be critical to have appropriate awareness campaigns in the area of palliative and hospice care services

The Board of Directors of Blue Cross Blue Shield of Massachusetts (BCBSMA) has chosen Executive Vice President Andrew Dreyfus as the company's new president and chief executive officer. Dreyfus succeeds Bill Van Faasen who has served in an unpaid interim role of president and CEO since March 16, 2010.

Consumer driven health plans (CDHPs) in the U.S. experienced continued growth this year, albeit at a slower rate than in 2009, according to preliminary results released by United Benefit Advisors (UBA) from its "2010 UBA Health Plan Survey."

Though the debate and eventual passage of the Patient Protection and Affordable Care Act (PPACA) filled news cycles for months, the bill ? and healthcare in general ? are so complex that plans have been working overtime to explain the many provisions of the new law.

According to the Foundation for Health Coverage Education (FHCE), on September 23, the Patient Protection and Affordable Care Act will allow consumers who purchase new or revised insurance plans or policies to receive an array of preventive care services with no out-of-pocket cost. The Foundation cautions that this provision could instead lead to out-of-control medical costs, which will escalate insurance premiums.

Because members are becoming more cognizant of their out-of-pocket expenses, many are turning to complementary and alternative medicine therapies as a less-expensive alternative

Health plans must accurately assess the overall opportunity for their individual business.

Express Scripts can sum up its overall strategy with a concept its CEO calls "Consumerology." The philosophy is based on the convergence of consumer behavior and healthcare.

State health directors breathed a loud sigh of relief last month when Congress finally managed to approve added funding for Medicaid just before leaving Washington for its summer recess.

Many organizations have started filing patent applications directed to such business improvements, such as online insurance claims formatting and filing, for example.

Conventional wisdom says families should set aside an emergency fund for unexpected expenses, however, one consumer group is recommending that health insurers' emergency funds should be rigorously examined.

When it comes to minor care episodes, time isn't the only thing wasted in emergency rooms. Anthem Blue Cross and Blue Shield in Virginia recently launched a program to reduce unnecessary emergency room visits.

Exchanges could bring in millions of potential customers. Insurers need to begin formulating marketing plans now.

While many health plans already have an appeals process in place for self-insured employers under the Employee Retirement Income Security Act, new federal rules clarify the process for consumers to challenge denials and rescissions.

For technology professionals leading IT efforts among health plans, the biggest changes haven't come from hardware and software, but rather, from their roles in implementing new business concepts.