Health Care Delivery

Self-funded employee health benefits are becoming increasingly prevalent as employers seek ways to reduce healthcare expenses, increase plan flexibility, manage risk, and tailor plans to what their workers really want and need.

Governor Asa Hutchinson seeks changes to Arkansas' first-of-its-kind Medicaid expansion waiver, which may include workforce training requirements and higher out-of-pocket costs for those newly insured.

An analysis of data available on HealthCare.gov and 12 state-based exchanges while consumers shopped for plans found that sites should take more steps to better support consumers in making informed health plan decisions.

Alaska Governor Bill Walker (I) announced in July that he would expand Medicaid in his state despite the legislature's decision to block his efforts, and now the Republican-controlled body is suing him.

Since the first open enrollment period under the Affordable Care Act, enrollment in Medicaid has increased 21% and the program needs to be reinvented to keep up with future healthcare needs.

Enrollees on the public health insurance exchanges have shown themselves to be savvy, informed consumers, according to the results from the 2015 Survey of US Health Care Consumers report from the Deloitte Center for Health Solutions.

Millions of exchange plan enrollees are missing out on subsidies available under the Affordable Care Act because they picked a non-qualifying health plan.

As California reduced the number of adults ages 19 to 64 years without health insurance by 15.5% from 2013 to 2014, Medi-Cal enrollment among the same age group rose from 12.9% to 19.2% during the same time period, according to new data from the UCLA Center for Health Policy Research.

Many proposals to modify the Affordable Care Act include eliminating the individual mandate, which remains unpopular, but doing so would have significant effects, according to a RAND analysis.

Close to 1 million new consumers selected a plan through HealthCare.gov because they qualified for a special enrollment period, according to a report from CMS.

A report from the Government Accountability Office has found that a program for hospitals serving poor and uninsured patients has created perverse incentives to prescribe more drugs and more expensive drugs, particularly in the area of cancer care.

The recent mergers between healthcare payers continue the trend of consolidation that has swept the healthcare industry since passage of the ACA.

More employers are requiring prior authorization and the use of select specialty pharmacies for high-cost drugs.

Although the Affordable Care Act has helped many uninsured Americans receive coverage over the last couple years, the health law is essentially underfunded by approximately $500 billion.

The Pregnancy Discrimination Act of 1978 prevents questions about status from being asked, and does not require a woman to disclose her pregnancy in an interview.

Medicare and Medicaid billing fraud scams-upcoding and unbundling schemes, double and triple billing, phantom billing and illegal kickback schemes -cost the United States an estimated $100 billion annually, inflating the size of government, escalating healthcare costs and burdening taxpayers.

A Gallup survey found that only Texas still has 20% of adults who lack insurance. In 2013, 14 states had uninsured rates above 20%.

States that are unable to accelerate their efforts to slow Medicaid spending will face long-term budget imbalances, according to a new report from Fitch Ratings.

For many US community cancer centers, keeping the doors open has often meant making the difficult decision to consolidate with hospitals and large hospital systems. Site neutrality is a critical step in the journey toward better healthcare for all Americans and a healthy future for Medicare.

Donald Trump's call to "get rid of the artificial lines" references a discussion about the optional federal insurance charter, which has been going on in business circles for more than 15 years.

Households that received financial help for health insurance under the Affordable Care Act are now having tax return issues, which could jeopardize their eligibility for subsidies next year.

Defining what is "medically necessary" is a judgment call, and patients may lack access to the criteria insurers use to make coverage decisions.

Safety net hospitals in California are using a car manufacturer's model to improve efficiency while saving on care costs.

The most recent issue of the CDC's Morbidity and Mortality Weekly Report analyzed the first data available on the functional types of disability in a state-based health survey and determined prevalence of functional disability.

Proposed mergers of Aetna and Humana, and Anthem and Cigna, raise questions of whether consumers will continue to see competition in health insurance markets.

Fifty years ago today, President Lyndon B. Johnson signed the law that created Medicare and Medicaid, setting in motion not only the greatest change in healthcare in the nation's history at that point, but also a lasting change for society.

Healthcare spending growth between 2014 and 2024 is projected to be substantially lower than the 3 decades prior to 2008, according to a new report from CMS. In addition, the average premium for a basic Medicare Part D prescription plan will remain stable in 2016.

Increasing health insurance enrollment is only one part of the goal of the Affordable Care Act-the law also aims to improve population health and lower healthcare costs, but less attention has been paid to these critical steps.

A quirk in Alaska law allowed Governor Bill Walker to move ahead without support from the legislature.

While growing marketplace enrollment in state-based exchanges is important, retaining enrollees is equally so, and a new report from the Robert Wood Johnson Foundation and the Urban Institute analyzed the renewal process for 6 states.