Michigan has awarded its bids to health plans administering Medicaid throughout the state, granting additional territory and clout to two regional players and rebuffing another major plan's attemp…
With the economy hitting California hard, the pressure is on more than ever for health insurers to respond to the small employer group market, in particular, with plan designs that get the premiums do…
Oregon's Drug Effectiveness Review Project is just the kind of independent comparative study of prescription drugs that health policy makers are looking to as they try to trim healthcare costs tow…
Health plans have begun to put generic dispensing goals into their pay-for-performance packages with some health plans. Advocate Physicians, which works closely with its payors, instituted a focused g…
Biologics used to treat immune diseases cost much more than their small-molecule counterparts, and so their use involves costs disproportionate to the number of patients treated. As a result of thi…
Colorado has kicked off a broad medical home project in 17 primary care practices around the state. Those physicians will receive standard fee-for-service, a monthly care management fee and bonuses fo…
A significant medical home pilot program has begun in the Phoenix and Tucson areas in which UnitedHealthcare is offering additional payments for primary-care providers involved in the treatment of pat…
Fallon Community Health Plan, based in Worcester, Mass., is reacting to local market dynamics in announcing its intention to expand into neighboring New Hampshire. The Massachusetts market is dominate…
As many as seven patient-centered medical home projects have cropped up throughout Ohio with CareSource working with providers on a Medicaid-focused PCMH. A medical-home initiative in Cincinnati inclu…
Recent moves to better control pharmaceutical expenses at the large TennCare program for Medicaid beneficiaries have resulted in compliance to preferred drugs by about 98 percent of the program's…
Two collaborative efforts involving multiple health insurers in Pennsylvania have the potential to improve the quality of healthcare in the state. The first is a transparency effort involving how care…
UnitedHealth's recently-competed purchase and integration of Sierra Health Services has made it the undisputed leader in Nevada's healthcare market, but new competition from Coventry and a new…
Both Virginia and Maryland lawmakers took steps to make insurance for small businesses more affordable in their 2009 sessions. In Virginia, lawmakers passed legislation allowing health plan designs to…
Despite a $6.6 billion two-year budget deficit, Wisconsin is going ahead with plans to expand its BadgerCare Plus program to childless adults. And, because the budget calls for state health officials…