Blue Cross Blue Shield of Michigan got only a portion of the insurance reforms it sought in the Michigan legislature, at least in part because of opposition from its competitor health plans. But the c…
New York's proposal to curb “fourth tier” drug pricing has health plans alarmed that lawmakers might curb their ability to structure health benefits, particularly in cost-sharing for exp…
Massachusetts is at a crossroads with its Commonwealth Care and Choice programs with enrollment exceeding expectations but costs coming in over earlier estimates. The Massachusetts Legislature is cons…
Two Louisiana-based health plans – Peoples Health and Vantage Health Plans – are succeeding in the Medicare Advantage space despite competition from larger, national plans. The three managed care heal…
If being Number Two means you try harder, then that explains the expansion and new product efforts by Medica and Health Partners, the second- and third-place health plans in Minnesota respectively. Bo…
Kaiser Permanente is preparing to make a huge strategic leap beyond its gatekeeper HMO roots by rolling out an administrative services only (ASO) product offering to large employers. The Department of…
Managed care plans participating in one of the nation's largest Medicaid managed care programs – in Ohio – are experiencing difficulties in maintaining their profit margins, highlighted by the dep…
Cariten Healthcare, a small provider-owned health plan based in Knoxville, walked away from the crowded field of contenders for the east Tennessee region TennCare contract, a contract viewed as highly…
A much-awaited bidding process for managed care plans to serve Medicaid beneficiaries in Washington, D.C., resulted in the selection of its three existing MCOs, as well as Unison Health Plan, which is…
Pennsylvania health plans have seen great success in managing their pharmacy costs – through encouraging the use of generics, aggressive formulary management, and copay structures. But the conundrum p…
Wisconsin is joining the ranks of states who are carving out the pharmacy benefits in their Medicaid and other health programs in an attempt to maximize rebates from drug manufacturers. And though the…
The rapid growth of Florida's population is creating opportunities for the state's health insurers, who are targeting second-tier metropolitan regions such as Naples and Marco Island for new p…
The Michigan health insurance industry has been preoccupied with a legislative battle over the individual health insurance market that pits Blue Cross Blue Shield of Michigan against other health plan…
Anthem Blue Cross and Blue Shield in Connecticut, Aetna, AmeriHealth Mercy and UnitedHealth Group plan to submit bids for the care management contracts for residents eligible for Medicaid and the Chil…
Illinois' healthcare industry may see CIGNA HealthCare emerge as a more formidable player in the ASO and small group sectors thanks to its purchase of Great-West Healthcare. While Great-West was n…