Healthcare policy and regulation

Policy and regulation significantly affect payers by dictating the standards for health plan offerings, determining coverage requirements, and influencing cost structures. These rules also guide patient data management, ensuring privacy and security, and play a crucial role in shaping overall healthcare market competition, payer strategies and healthcare spending.

Top Stories

News 15 Jan 2026
Trump unveils healthcare affordability plan

The "Great Healthcare Plan" is vague, but would send money directly to ACA enrollees and entrench Trump’s drug pricing deals. Continue Reading

— Healthcare Dive
News 13 Jan 2026
2026 ACA enrollment lags by 1.5M signups amid subsidy fight

ACA marketplace enrollment decreased for the first time since 2020, potentially due to lapsed premium subsidies. Continue Reading
By
- Sara Heath, Executive Editor

News 07 Jun 2019
How Does the Health Payer, Insurance Industry Support the Economy?

Health payers generate economic growth by providing insurance coverage, creating jobs, and making tax contributions, according to AHIP. Continue Reading
By
- Sara Heath, Executive Editor
News 22 Apr 2019
How to Be More Efficient in HEDIS Reporting

By remediating gaps in data collection, health plans can immediately improve the efficiency of HEDIS reporting. Continue Reading
By
- Veradigm
News 13 Nov 2017
Top 5 Most Common Healthcare Provider Fraud Activities

The most common healthcare provider fraud activities drain public payer finances and promote unsafe care conditions for beneficiaries. Continue Reading
By
- Thomas Beaton
News 20 Sep 2017
Top 10 Healthcare Spending Categories in the United States

Many of the highest healthcare pending categories in the US continued to climb as indicated by significant growth in expenditure amounts. Continue Reading
By
- Thomas Beaton
News 15 Jun 2017
AMA, AHA Call for Stronger Patient Insurance Protections

The AMA joins other prominent health industry groups in calling on the Senate to address patient insurance protection concerns. Continue Reading
By
- Jesse Migneault
News 18 May 2017
CMS to Shutter Small Business Health Options Program Website

CMS will close its portal allowing small business to enroll members on the health insurance exchanges due to low usage rates. Continue Reading
By
- Jesse Migneault
Feature 04 Nov 2016
The Progress and Challenges of the Affordable Care Act

Various clauses of the Affordable Care Act brought obstacles for insurers to overcome. Continue Reading
By
- Vera Gruessner
Answer 15 Jun 2016
How the Affordable Care Act Changed the Face of Health Insurance

Why have health insurance rates gone up after the Affordable Care Act was implemented? Continue Reading
By
- Vera Gruessner

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