Reimbursement

Inspired by the links between activity, meditation and wellbeing, the country's largest mutual insurer is sponsoring an app to help its members and the public take on stress.

Blue Shield of California is in the position of trying to keep its state tax exemption, while also defending its public image and defining its future mission to customers.

How much overhead in private and government insurance will it take to have universal coverage under the ACA? Quite a bit in one current view of the data.

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped.

After more than a decade of legal turmoil, physicians in four states have won a concession from the nation's largest insurer to make getting paid less of a hassle, if not to get paid more.

Among the major changes proposed for Medicaid plans are new provider adequacy standards, new mandates for capitated rate setting, beneficiary protections in long-term care, forthcoming quality ratings, and an 85 percent medical cost administrative ratio.

The federal government has crafted the first regulatory change to Medicaid managed care in a decade, as more health plans take the challenge from states to cover growing Medicaid populations at a sustainable cost.

New Hampshire ACO's goal is to have capitation make up 70 percent of reimbursements, dropping fee-for-service from its current 50 percent to 30 percent.

The move could affect 3,500 UPMC employees who are at least 60 years old and have 10 years on the job.

As California goes, so goes the country in capping consumer costs for medicines? That's what patient advocacy groups and and some pharmaceutical companies may be hoping.