Texas' health plans have long benefitted from the Lone Star State's mandatory generic dispensing law, but have gone beyond that to achieve significant generic utilization and subsequent saving…
Massachusetts is at a crossroads with its Commonwealth Care and Choice programs with enrollment exceeding expectations but costs coming in over earlier estimates. The Massachusetts Legislature is cons…
If being Number Two means you try harder, then that explains the expansion and new product efforts by Medica and Health Partners, the second- and third-place health plans in Minnesota respectively. Bo…
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…
Cariten Healthcare, a small provider-owned health plan based in Knoxville, walked away from the crowded field of contenders for the east Tennessee region TennCare contract, a contract viewed as highly…
A much-awaited bidding process for managed care plans to serve Medicaid beneficiaries in Washington, D.C., resulted in the selection of its three existing MCOs, as well as Unison Health Plan, which is…
Pennsylvania health plans have seen great success in managing their pharmacy costs – through encouraging the use of generics, aggressive formulary management, and copay structures. But the conundrum p…
Blue Cross and Blue Shield of North Carolina is upping the ante on transparency with its new Health Cost Estimator by offering contracted prices instead of provider charges, and by estimating the cost…
The rapid growth of Florida's population is creating opportunities for the state's health insurers, who are targeting second-tier metropolitan regions such as Naples and Marco Island for new p…
Anthem Blue Cross and Blue Shield in Connecticut, Aetna, AmeriHealth Mercy and UnitedHealth Group plan to submit bids for the care management contracts for residents eligible for Medicaid and the Chil…
Illinois' healthcare industry may see CIGNA HealthCare emerge as a more formidable player in the ASO and small group sectors thanks to its purchase of Great-West Healthcare. While Great-West was n…
Massachusetts' health reform program got off to an encouraging start in 2007 with more than 300,000 previously uninsured residents receiving health benefits; however, problems loom with higher-tha…
Health plans operating in the Toledo area largely have deserted a holdover of 1980s managed-care contracts by eliminating “steerage,” which sent patients to a single, large hospital system….