Reimbursement

Fewer than one-quarter of hospitals in the United States are on track to hit the Obama administration's 2018 goal of providing at least half of their patient care through value-based arrangements -- structures that tie reimbursement from Medicare to the quality of care patients receive.

Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released Thursday.

The Carolinas Healthcare system on Thursday was slapped with an antitrust suit by the state of North Carolina alleging that the system's Charlotte-Mecklenburg Hospital Authority used its large size to exert market power in dealing with commercial health insurers and to negotiate higher reimbursement rates for treating insured patients.

The Consortium of Independent Physician Associations has formed a new Medicare Shared Savings Program Accountable Care Organization for Michigan and Ohio physicians.

The Centers for Medicare and Medicaid Services has temporarily suspended its review of short stay patient claims to give reviewers time to improve the standardization around the two midnight rule, CMS said in a June 6 update.

In a new rule issued Wednesday, CMS is shutting down loopholes that allow short-term plans to operate outside the policies governing the ACA's single risk pool.

Clinical event notifications promote well coordinated, patient-centric care for New York Health Plan members.

Medicare is ambulatory care's favorite insurer when it comes to getting paid faster, according to a new peer60 survey of close to 800 ambulatory care providers.

The portion of released prisoners with addiction problems who lacked medical insurance fell sharply after the health law's Medicaid expansion took effect, but drug-treatment rates for ex-offenders barely budged, a new study shows.

If you're one of the nearly 44 million Americans estimated to have a mental health condition, the 2010 health law is supposed to help you get treatment. Yet actually getting that help depends, new research suggests, on who you are and, to an extent, on your racial background. While more people overall are getting mental health care, it's still harder to do if you are not white.