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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

Many fear that the $5 billion allocated by the federal government for high-risk insurance pools won't last until 2014

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.

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.

Neuropathic pain presents a difficult challenge. When the peripheral or central nervous system isn't functioning correctly, it can lead to pain that continues for months or years.

Whether you're moving forward with an acquisition, with a sale or by outsourcing, remember some things will never change.

Weight management agents in late-stage development.

Recent FDA Approvals (through July 2010) related to Tribenzor, Daiichi Sankyo, Aricept, Eisai and Pfizer, Daytrana, Glassia, Zuplenz, Infergen, Cuvposa

Fingolimod is an investigational drug being studied for the treatment of relapsing-remitting multiple sclerosis (RRMS) and may represent a first-in-class sphingosine 1-phosphate receptor modulator as well as the first oral therapy for the treatment of RRMS.

Multiple sclerosis (MS) is a significant cause of disability among young adults, more commonly women, and usually strikes patients in the prime of their lives. Despite recent therapeutic advancements, MS remains an incurable, chronic illness. Clinical evidence supports the role of disease-modifying therapy early in the disease course to reduce the number of acute attacks, delay disease progression, maintain quality of life, and prevent disability.

In patients with low back pain of at least moderate severity and lasting for at least 6 weeks, a new 7-day buprenorphine transdermal system was found to provide better pain control, improve sleep quality, and health-related quality of life as compared with placebo.