Humana Inc.'s latest stop on its buying spree was in East Tennessee where the Kentucky-based insurer agreed to purchase Cariten Healthcare, a provider-owned company doing business in commercial, M…
Blue Cross Blue Shield of Michigan has made its own in-house provider portal into the go-to site for Medicare elibibility and benefit information, even for those who are not its customers. In…
The end of private fee-for-service Medicare plans by 2011 has health plans moving to re-shape their Medicare Advantage strategies, building networks where it makes sense to do so, or retreating from s…
Horizon Blue Cross Blue Shield's planned conversion to for-profit status stands a markedly better chance this time, as it would raise $1 billion or more that New Jersey could use to launch propose…
Tufts Health Plan wants to compete in the Rhode Island market, setting the stage for a showdown with Blue Cross & Blue Shield of Rhode Island, the state's no. 1 insurer, and UnitedHealthcare o…
The state agency that manages the Medicaid managed care program is keeping seven of its current managed care plans in its latest procurement, and it will add a subsidiary of Centene Corp. to its line-…
Iowa's governor has signed a healthcare reform law that increases coverage for children with family incomes up to 300 percent of the federal poverty level. The legislature also expanded the abilit…
Health plans in the Carolinas are managing specialty pharmacy costs at virtually every step of the process, from negotiating prices with manufacturers to creating special convenient networks. Blue Cro…
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…
TennCare, the large Medicaid managed care program, recently awarded two new contracts to health plans to manage the care for enrollees in west and east portions of the state. The contracts went to Ame…
Maryland has become one of the first states to pass laws regulating the licensing and transparency of pharmacy benefits managers operating in the state. The bills were supported by the Pharmaceutical…
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…
Summary Healthcare reform fizzled out in both Kansas and Missouri in the past legislative sessions. A legislative revolt from his own party forced Missouri Gov. Matt Blunt to back off his Insure Misso…
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…