A stagnant economy and record unemployment have prompted health insurers to alter their plan designs and drug formularies in the Nevada market. HMO market share has eroded by 8 percentage points betwe…
Though Iowa has the second lowest health insurance premium rates nationwide, brokers and industry insiders warn that premiums, which went up 11 percent for many Iowa businesses over the last year, are…
Three major insurers — Anthem Blue Cross and Blue Shield, Humana and UnitedHealthcare — have teamed up with 11 local physician group practices and a local organization to pilot a patient-centered m…
Minnesota health plans are facing the specter of rising specialty drug costs and are implementing a variety of strategies to control those costs, including shifting specialty drugs from the medical be…
Pennsylvania stands out from most states because of the dominance of four Blue Cross Blue Shield plans that operate, for the most part, exclusively in their own territories. Whether the Blue plans’ un…
South Carolina's expanded Medicaid managed care program attracted a crowd of health plans interested in insuring beneficiaries, but the crowd is thinning with two MCOs throwing in the towel in 200…
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…
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…
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…
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…
Missouri's Medicaid program is preparing to centralize management of pharmaceutical benefits for some 850,000 beneficiaries across the state. Previously, managed care plans managed the pharmacy an…