Politics and Policy

Doug Chaet, senior vice president, Provider Networks and Value-Based Solutions at Independence Blue Cross, shares five strategies that can help providers succeed in value-based reimbursement models.

Democratic presidential candidate Hillary Clinton vows to provide more affordable, cost effective, accessible, and higher quality healthcare and insurance coverage. Here’s a closer look at seven key ways Clinton would change the healthcare system if elected president.

Drug coupons sound good on paper for both manufacturers who sell more products and for patients who pay less for a high-priced new product. But payers and pharmacy benefits managers are not impressed.

A look at how Trump's specific plans for healthcare could impact the industry.

Though technology companies are continuing to innovate in the wearable field, healthcare organizations are slow to adapt.

A look at how each GOP candidate’s specific plans for healthcare could impact the industry.

New regulations will check the drive to narrow networks, just as the business case for forming them grows more compelling.

Democratic presidential candidates Bernie Sanders and Hillary Clinton both vow to make healthcare more affordable, accessible, and higher quality. Here’s a closer look at two of the ways Sanders proposes to do this.

After suffering significant losses on the health insurance exchanges in 2015, insurance giants UnitedHealth Group and Aetna announced they may leave the exchanges next year.

A glimpse into the present and future of healthcare industry mergers and acquisitions

IMS Health expert predicts future drug spending trends and ways to curb rising costs at the AMCP 2016 conference.

Industry watchers weigh in on UnitedHealth Group’s announcement that it will exit all but a “handful” of state Affordable Care Act (ACA) exchanges.

Republican presidential candidate Donald Trump recently unveiled his 7-point healthcare plan. Find out more.

At the AMCP16 conference, Managed Healthcare Executive invited some of the nation’s leading pharmacy and managed care experts to join us to discuss some of the most critical managed care pharmacy challenges facing the industry.

Covered California adopts significant new changes to its contracts with health insurers as part of an aim to take health care reform to the next level.

Comprehensive Primary Care Plus (CPC+) advanced primary care medical home model aims to strengthen primary care through a regionally-based multipayer payment reform and care delivery transformation.

A new study explores the tangible effects of the ACA and the study author weighs in on the implications for managed care.

Experts says UnitedHealthcare’s new boutique-style health plan is designed to drive innovation in primary care.

As a result of a recent case decided by the U.S. Supreme Court, advocates of healthcare transparency may need to adjust their data collection strategies.

Following on the heels of UnitedHealthcare, Highmark weighs whether staying on the exchange marketplace will be viable.

Medicare Advantage plans that are slow to submit risk adjustment data are at a big disadvantage.

CMS regulation will lead to major changes in Medicaid managed care programs; changes that focus on quality improvements, increased transparency and accountability, and strengthened state and federal oversight.

Some experts argue that prescription drug monitoring programs can be a game changer when it comes to curbing prescription abuse and misuse. Here are 11 states that stand out for their PDMPs (or lack thereof).

A recent Supreme Court decision shines the spotlight on the healthcare price transparency debate.

As patients look to make more informed decisions about healthcare services, payers can leverage comparative analytics to deliver greater price transparency

Here are three questions payers must ask to determine providers’ readiness to engage in risk-based reimbursement.

State and federal regulations, health information breaches, create a minefield of issues

Concerns among stakeholders may call for EHR system revamping

An in-depth look at the effects of PDMPs, which are electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients.

While value-based reimbursement presents opportunities for payers and providers, succeeding in such a reimbursement model can be challenging. Here are four things to strive for that could increase the likelihood of success in a value-based reimbursement model.