Reimbursement

Consultants hired by the health system that owns Nantucket Cottage Hospital in Massachusetts made several errors that led to lower wages being reported to Medicare for the hospital, which could potentially lead to a $160 million drop in federal Medicare payments over the next fiscal year for facilities across the state.

The implementation of MACRA and the introduction of the Quality Payment Program is "flexible common-sense approach" for paying physicians, acting Centers for Medicare and Medicaid Services chief Andy Slavitt said at the American Hospital Association's annual membership meeting this week, though the government is actively seeking feedback on the new program.

(SPONSORED) The advent of population health presents challenges and opportunities to payers.

Humana may become the second major insurer to exit the exchange business in certain states, as it reported losses Wednesday stemming from that market.

Gallina succeeds Wayne S. DeVeydt, who, after more than a decade of service to Anthem, including 9 years in the executive vice president and chief financial officer role, decided to step down from the position effective May 31, citing family commitments and philanthropic work.

Insurers are picking up more of the cost of prescription pain drugs, according to a study linking that trend with the rise in opioid-related deaths.

Barred from restaurants, banned on airplanes and unwelcome in workplaces across America, smokers have become accustomed to hiding their habits. So it's no surprise many may now also be denying their habit when they buy health coverage from the federal health law's insurance exchanges.

ACO Partner takes on upfront costs of services and technology for physician practices, other providers to transform to value-based payments.

Proposed regulations released last week by the Centers for Medicare and Medicaid Services are raising concerns that the playing field is uneven, with 87 percent of solo practitioners getting penalized and 81 percent of clinicians in large groups earning bonuses, according to some estimates.

In the 2017 open enrollment period, the Centers for Medicare and Medicaid Services will pilot a program on Healthcare.gov to pair results of a 5-star care rating with health plans on the federal marketplace.