Commercial health insurers in the Indiana-Kentucky-Ohio region have experienced declining enrollment due to the economic effects of employers dropping or cutting workplace-sponsored coverage. But insu…
The passage of the Patient Protection and Affordable Care Act has the potential to dramatically increase Medicaid and commercial enrollment in Ohio, Kentucky and Indiana with expansion of Medicaid eli…
The economy has inspired fewer bold moves and more fiscal caution in the TriState health insurance market, both in government and the private sector. Connecticut is experiencing a seismic shift in its…
Ohio has decided to carve out Medicaid pharmacy in anticipation of the passage of a new federal law, the Drug Rebate Equalization Act. The Act will give managed care companies the same rebates – aroun…
Employers in North Carolina and South Carolina are turning to so-called hybrid plans to help them continue to offer coverage in one of the regions worst hit by job losses. The hybrid plans combine fea…
Blue Cross and Blue Shield of Kansas City has engaged a medical home pilot with TransforMED, bringing new technologies to 13 medical practices in its operating regions. The practices can build the med…
Kansas Medicaid members could face a preferred drug list and a streamlined prior authorization process, which could widen the number of therapeutic classes the state covers. These changes are borne ou…
Big contracts were renewed or awarded for the first time in the Mid-Atlantic this summer. Anthem Blue Cross and Blue Shield (the largest health insurance carrier in Virginia) and Kaiser Permanente wil…
Wisconsin state officials are dictating to state HMOs that changes be made in how care is delivered in the state's Medicaid/BadgerCare Plus program. Faced with unacceptable HMO quality scores as w…
The recession severely damaged Florida insurers in 2008 as the ranks of commercially insured members dropped by 1.2 million last year amid layoffs and benefit cuts at Florida businesses. Every signifi…
Texas has taken its largest step yet toward addressing the nation's worst uninsured rate by green-lighting the first step toward Healthy Texas, a reinsurance program that could allow small busines…
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…
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…
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…
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…