Reimbursement

The 31 states and District of Columbia that have expanded Medicaid are saving millions -- and in some cases, tens of millions -- compared to states that have not adopted the federal program, according to a report released Tuesday by the Robert Wood Johnson Foundation.

Errors in insurance claims are costing the healthcare industry billions in wasteful spending, and both the payers and the providers are at fault, experts say.

The Maine Bureau of Insurance is closely monitoring Community Health Options, as the nation's only profitable co-op under the Affordable Care Act in 2014 posted a net loss of $74 million for 2015 and 2016 this month, according to information on the maine.gov website.

The percentage of drugs requiring coinsurance has climbed steadily, increasing from 35 percent in 2014 to 45 percent last year. That percentage is approaching two-thirds of all covered drugs.

The Supreme Court has sided with Liberty Mutual Insurance and against the state of Vermont in a decision that could have implications for insurers nationwide.

Each year, a large portion of healthcare spending is on services for which consumers could price-shop ahead of time, a new study finds, suggesting that price transparency is an important factor in cutting down on healthcare costs.

While hospitals build wellness centers, insurers too are investing in programs that have moved beyond tobacco-free living sessions and gym membership benefits.

Over 300 healthcare and patient advocacy organizations sent a letter to Senate and House leaders on Thursday urging them to press the Centers for Medicare and Medicaid Services to permanently withdraw a reduced Part B drug payment model from consideration.

Consumers were urged to buy policies in their 50s, because premiums rose the longer they waited. About 4.8 million people were covered by long-term care policies in 2014. But insurers botched just about every aspect of the policies they sold in the early days of the industry, said Joseph Belth, a retired professor of insurance at Indiana University known as one of the insurance industry's toughest critics.

The Aetna Whole Health-Virtua plan will be introduced in South Jersey later this year and will use Virtua's community-based health system of hospitals, outpatient facilities, urgent care centers, and health and wellness centers.