Reimbursement

Though supply chain professionals are keenly aware of the importance of quality and cost, their clinical counterparts may not be as familiar with an organized movement to link these two components with patient outcomes.

More and more states are turning to all-payer claims databases to try to bring the ideas of transparency and shopping to reality.

Federal officials are preparing the first major regulatory update to Medicaid managed care in a decade, promising to challenge insurers but also fix long-standing issues and offer routes to business standardization.

How will a long-time health insurance executive fix the healthcare financing crisis in a state with some of the most expensive and advanced medical care on the planet? Starting in January, Massachusetts is going to find out.

Hospitals dependent on Medicaid disproportionate share allocations must discover new financing models for low-income patients, or else lobby their state governments to make policy changes.

The re-election of Republican governors in closely contested races in Florida, Georgia, Wisconsin, Maine and Kansas dims the chances of Medicaid expansion in those states.

Health insurers in the nation's largest market are breathing a collective sigh of relief after escaping a new rate review system, but they may have to fight the battle again.

How will a long-time insurance manager fix the crisis in a state with some of the most expensive and advanced healthcare on the planet?

A federal court is letting a wellness program's financial penalties take effect, but is considering the question of how much is too much, leaving corporate America and insurers waiting.

In the quest for population health, lifestyle interventions for diabetes may pose the biggest rewards and most vexing challenges. Some are making progress, however.