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Every company has sensitive employee information. That means HR leaders should take on more cybersecurity responsibility, sources say. Cybercriminals famously prefer certain types of data. Anyone working in healthcare or [...]

Byline: Brian Eastwood By Brian Eastwood In the years since the Affordable Care Act went into effect, and brought with it the concept of value-based care, insurers have introduced a [...]

Byline: Brian Eastwood Now that America's Health Insurance Plans' 2015 http://www.fiercehealthpayer.com/tags/ahip-institute has come and gone, the industry's lobbying group has turned its attention to its next major task--replacing longtime President [...]

Byline: Brian Eastwood Insurers are turning to familiar terminology in their latest effort to thwart rising prescription drug prices, https://www.bostonglobe.com/business/2015/06/11/sky-high-drug-prices-under-pressure-insurers-push-pay-for-performance/JOERSUOnlAFeDKIzVTrO0H/story.html The Boston Globe : Pay for performance. With the http://www.fiercehealthpayer.com/story/pricey-hep-c-drugs-force-insurers-ethical-dilemma/2014-05-06 [...]

Byline: Brian Eastwood The http://www.fiercehealthpayer.com/story/how-humana-acquisition-would-reshape-market/2015-06-08 stands to benefit payers while challenging hospitals and providers, http://www.healthcaredive.com/news/humana-sale-good-for-payers-bad-for-providers/400497/ Healthcare Dive . http://www.fiercehealthpayer.com/story/humana-enters-quiet-period-until-july-29-refueling-acquisition-rumors/2015-06-09 amid rumors that Aetna, Anthem or Cigna may make a deal [...]

Byline: Brian Eastwood States that find themselves in need of an insurance exchange in the wake of the King v. Burwell verdict may be in luck thanks to a cloud-based [...]

Byline: Brian Eastwood Much of the rhetoric associated with reducing healthcare costs rightfully focuses on the top of the proverbial pyramid--patients with multiple comorbidities who make up 1 percent of [...]

Byline: Brian Eastwood As the baby boomer population enters its Medicare years, beneficiaries tend to be sicker than their predecessors. They also live longer. The combination will strain both beneficiaries [...]

Byline: Brian Eastwood As the health insurance market continues its shift to http://www.fiercehealthpayer.com/tags/consumer-driven-health-plans-0 , payers gain an edge by implementing technology that improves consumer engagement as well as the management [...]

Byline: Brian Eastwood Unnecessary administrative costs contribute to approximately $800 million of waste in coordination of benefits alone for the health insurance industry each year, according to Robin J. Thomashauer, [...]

Byline: Brian Eastwood For health plans, the case for robust analytics comes down to the numbers. Medication to treat hepatitis C costs $1,000 a dose, and patients who miss a [...]

Byline: Brian Eastwood Former Massachusetts Governor and 2012 Republican Presidential candidate Mitt Romney defended his landmark universal healthcare reform in a keynote at America's Health Insurance Plans (AHIP) Institute. However, [...]

Byline: Brian Eastwood Former President Bill Clinton called for an inclusive and collaborative approach to healthcare reform in his closing keynote address for the America's Health Insurance Plans AHIP Institute. [...]

Byline: Brian Eastwood America's Health Insurance Plans kicked off its annual AHIP Institute with a call for innovation and a surprise appearance from outgoing President and CEO Karen Ignagni. 'It's [...]

Byline: Brian Eastwood http://www.fiercehealthpayer.com/story/humana-still-attractive-acquisition-target-priced-too-high/2015-06-02 for insurers who want its booming Medicare Advantage business. With 12,000 employees, Humana is also the second-largest company in Louisville, Kentucky--and Mayor Greg Fischer (D) and [...]

Byline: Brian Eastwood As http://www.fiercehealthpayer.com/story/humana-receives-interest-potential-buyers-may-sell/2015-05-29 , financial analysts remain divided on how much the company is worth. Humana stock closed at nearly $215 a share on Friday amid speculation that [...]

Byline: Brian Eastwood An examination of the medical loss ratio (MLR) in 2014 suggests that the financial performance of insurers has not changed substantially since the years before the Affordable [...]

Byline: Brian Eastwood The more insurers submit proposed rates for 2016 Affordable Care Act health plans, the more it becomes clear that rates could rise significantly, Politico http://www.politico.com/story/2015/05/how-affordable-is-the-affordable-care-act-118428.html . Today [...]

Byline: Brian Eastwood Roughly 4 million Georgia residents lack dental coverage, and many haven't seen a dentist in decades, Kaiser Health News reported. The issue: The Affordable Care Act didn't [...]

Byline: Brian Eastwood A http://www.fiercehealthpayer.com/story/house-gop-files-sues-obama-aca-implementation/2014-11-24 will get its day in U.S. District Court, the Associated Press http://www.denverpost.com/breakingnews/ci_28203920/first-hearing-house-lawsuit-over-obama-health-law . The lawsuit, filed in November, alleges that the Obama administration overstepped its [...]

Byline: Brian Eastwood The Centers for Medicare & Medicaid Services wants to bring quality ratings to Medicaid managed care organizations (MCOs). This week, http://www.fiercehealthpayer.com/story/cms-updates-medicaid-managed-care-organization-rules/2015-05-26 . As FierceHealthPayer previously reported, http://www.fiercehealthpayer.com/story/mco-rule-under-fire-introducing-medical-loss-ratio/2015-05-27 [...]

Byline: Brian Eastwood The http://www.fiercehealthpayer.com/story/cms-updates-medicaid-managed-care-organization-rules/2015-05-26 yesterday, and the rule is already under fire for proposing a medical loss ratio (MLR) of 85 percent for managed care plans. Medicare Advantage and [...]

Byline: Brian Eastwood The business outlook for http://www.fiercehealthpayer.com/tags/private-exchanges continues to improve even though the products have yet to reach their full potential, according to the results of an Array Health [...]

Byline: Brian Eastwood http://www.fiercehealthpayer.com/story/non-group-enrollment-spiked-2015/2015-05-21 , but many of those consumers that bought high-deductible plans do not think are a good value, Kaiser Family Foundation (KFF) President and CEO Drew Altman [...]

Byline: Brian Eastwood The http://www.fiercehealthpayer.com/story/karen-ignagni-leaving-ahip-emblemhealth/2015-05-21 for the same role at New York nonprofit insurer EmblemHealth comes at a critical time for the health insurance industry. If the Supreme Court sides [...]

Byline: Brian Eastwood Longtime America's Health Insurance Plans (AHIP) President and CEO Karen Ignagni is leaving the lobbying group to become president and CEO of New York-based insurer EmblemHealth. 'I [...]

Byline: Brian Eastwood Humana hopes the third year of open enrollment is the charm in Georgia, where a flood of enrollees has proven costly to the insurer, Bloomberg reported. Humana [...]

Byline: Brian Eastwood Missouri Gov. Jay Nixon (D) https://governor.mo.gov/news/archive/gov-nixon-announces-45-million-settlement-aetna-after-company-failed-provide-required that the state has reached a $4.5 million settlement with Aetna following two insurance law violations. It's the largest such settlement [...]

Byline: Brian Eastwood The http://www.fiercehealthpayer.com/story/state-ACA-exchanges-still-plagued-financial-challenges/2015-02-18 are no secret--and a recent Commonwealth Fund http://www.commonwealthfund.org/publications/blog/2015/may/state-marketplaces-and-financing-stability spelled out the struggles each state faces in its efforts to achieve financial sustainability. Collectively, the state [...]

Byline: Brian Eastwood A loophole in the Affordable Care Act's Health Insurance Providers Fee appears to benefit payers at the expense of state governments, the Associated Press reported. The fee [...]

Byline: Brian Eastwood Premiums for Affordable Care Act insurance plans are higher in counties that lack preferred provider organizations (PPOs), according to a HealthPocket analysis of premiums for plans sold [...]

Byline: Brian Eastwood The 2014 plan year was a good one for the nation's seven largest insurers, who collectively added 5.6 million members and generally saw profit margins in excess [...]

Byline: Brian Eastwood Nearly all employers who now offer health insurance to full-time workers will continue to do so in 2016, though the likelihood of offering coverage five years from [...]

Byline: Brian Eastwood Better investments in consumer-facing technology will help state exchanges attract customers and increase the likelihood of sustainability, http://ebn.benefitnews.com/news/exchanges/3-concepts-that-will-make-public-exchanges-sustainable-2746380-1.html Employee Benefit News . Two years into open enrollment, [...]

Byline: Brian Eastwood Spend enough time on the Internet and you eventually come across a meme called Florida Man. The term typically describes an oddball criminal committing the sort of [...]

Byline: Brian Eastwood The long-term effect of the so-called Medicaid pay bump mandated by the Affordable Care Act in 2013 and 2014 remains to be seen, according to a Health [...]

Byline: Brian Eastwood Add Covered California to the growing list of state insurance exchanges facing financial difficulties in the first year that Affordable Care Act exchanges are supposed to be [...]

Byline: Brian Eastwood The Hawaii Health Connector will shut down operations on Sept. 30, InsuranceNewsNet http://insurancenewsnet.com/oarticle/2015/05/10/insurance-exchange-sets-deadlines-in-preparation-of-ending-services.html . The exchange site will cease new enrollment this week, discontinue its outreach programs [...]

Byline: Brian Eastwood The Obama administration intends to fix two of consumers' biggest complaints about the Affordable Care Act, http://www.nytimes.com/2015/05/09/us/politics/health-care-law-consumer-complaints-to-get-addressed-by-white-house.html the New York Times : Inaccurate provider directories and surprise [...]

Byline: Brian Eastwood An analysis of data from nearly 689,000 patients with cancer found that rates of insurance coverage vary greatly by demographics and cancer type, according to Cancer , [...]

Byline: Brian Eastwood The U.S. Department of Veterans Affairs is no stranger to cyberattacks. In March, roughly 1.2 billion cyberattacks targeted the VA network, CIO Stephen Warren said at the [...]

Byline: Brian Eastwood It costs $10,000 more annually to treat Americans with diabetes than it does to treat those without the chronic disease, according to a Health Care Cost Institute [...]

Byline: Brian Eastwood Growth in http://www.fiercehealthcare.com/tags/hospice-care-0 from 2004 to 2009 reduced hospital use but nonetheless cost Medicare more than $6,700 per hospice beneficiary, http://www.nejm.org/doi/full/10.1056/NEJMsa1408705 the New England Journal of Medicine [...]

Byline: Brian Eastwood Most discussions about improving http://www.fiercehealthcare.com/tags/patient-engagement focus on technology--specifically, on the patient portal--but healthcare organizations cannot forget the human element of the relationship they have with their patients, [...]

Byline: Brian Eastwood Payers can use a combination of claims, lab and pharmacy data to apply risk stratification algorithms to their member populations, but they won't start to see savings [...]

Byline: Brian Eastwood Cost sharing can help employers and consumers alike spend less on healthcare, but the practice should be used with caution when it comes to the sickest patients, [...]

Byline: Brian Eastwood As a native of the Boston area, I often view California with a mix of awe, intrigue and bewilderment. What's it like to have cities laid out [...]

Byline: Brian Eastwood A yearlong http://www.businesswire.com/news/home/20150430006646/en/Study-Shows-Improved-Health-Participants-Integrated-Substance#.VUdg0flVikr by Humana and health management service provider Catasys determined that a population health-based approach to treating substance abuse improved enrollment in treatment programs while [...]

Byline: Brian Eastwood The Florida House and Senate remain divided on their approach to Medicaid expansion, which is getting wrapped up in larger, more contentious talks about the state budget, [...]

Byline: Brian Eastwood Medicare spent more than $103 billion on Part D prescriptions in 2013, according to a comprehensive http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html released by the Centers for Medicare & Medicaid Services (CMS) [...]