Reimbursement
Once again, insurance practices on cost-sharing and reimbursement for out-of-network providers and PPOs are ending up in dispute, with backlash from providers and customers.
An estimated $22 billion in healthcare spending would be lost due to those losing coverage under the Affordable Care Act, according to a new report by the Urban Institute of the Robert Wood Johnson Foundation.
Workers at Seattle's largest employer are signing up in droves for new ACO health plans led by regional health systems, who see the model as ripe for growth.
The U.S. Department of Defense can look like a benefits company "that occasionally kills a terrorist." The agency has to overhaul its healthcare contracting, especially TRICARE, according to advocates.
The Minnesota-based insurer expects to partner with up to 250 new ACOs this year.
The nation's largest insurer is making leaps in the journey of consumer-driven healthcare, improving its digital offerings and investing in new member incentives.
"Is this doctor in my insurance network?" is part of the litany of questions asked when considering whether to see a particular doctor. Unfortunately, the answer may not be a simple yes or no.
After decades of research showing at best mixed benefits, certificate of need programs are starting to look antiquated and deleterious in the age of consumer-driven healthcare.
Whether or not more co-ops falter, many insurers could learn from some of their goals and experiments, including in primary care.
Hospitals also saw a 55 percent reduction in uncompensated care visits in the first three quarters of 2014.