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…
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…
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…
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…
BlueCross BlueShield of South Carolina is more than just the 800-pound gorilla in the Palmetto State's healthcare market – it is parent to a family of successful subsidiary companies that provide…
Florida delivers managed care services to Medicaid beneficiaries in many ways, and now it's looking at adding yet another delivery system. In the summer of 2010, the state plans to test a medical…
Faced with hundreds of millions of dollars in tax increases from the state, New York health plans are hunkering down for a lean 2009. Four of the 10 major carriers in the state posted net losses in 20…
In what may be a coming trend among large-scale employers with self-managed pharmacy plans, General Mills has hired its own in-house pharmacists to do medication management with targeted employees….
Georgia is a testing ground for new product designs for group and individual buyers. Blue Cross and Blue Shield of Georgia has introduced new products geared to those who want coverage for essentials,…
Health insurers in Oregon and Washington are paying special attention to pricing in 2009 in order to maintain their customer base, but are also casting a wary eye to any blip in medical costs as the i…