With all eyes focused on the national healthcare reform debate, California is already tackling many of the same thorny issues raised by policymakers. Healthy San Francisco, the city/county’s 2-year-ol…
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…
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…
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…
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…
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at the nation’s publicly held health plans each quarter through their financial releases and conference call transcripts. T…
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…
The winds of change are about to reshape the TriState health insurance market, starting with the announcement that UnitedHealth Group is planning to buy Health Net of the Northeast within 12 months. I…
The effects of the recession continue to be seen among carriers in the South, particularly the Blues in both Alabama and Georgia where big drops in enrollment and earnings in 2008 were reported. Howev…
With the economy hitting California hard, the pressure is on more than ever for health insurers to respond to the small employer group market, in particular, with plan designs that get the premiums do…
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…
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…
Biologics used to treat immune diseases cost much more than their small-molecule counterparts, and so their use involves costs disproportionate to the number of patients treated. As a result of thi…
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…