Reimbursement

Health systems as well as independent providers have an opportunity to drive best practices in specialty care and secure sustainable revenue with a new business and care model.

Some health systems see value in becoming part of branded health plan networks for limited provider plans, as other providers try to launch their very own plans.

Some health systems are seeing value in becoming part of branded health plan networks for limited provider plans, as other providers try to launch their very own plans.

With an improving fiscal climate, some states are paying their Medicaid providers more. More states are increasing fees to specialists, nursing homes and managed care organizations, but 31 states were cutting or freezing Medicaid hospital rates, compared to 19 that were increasing them.

Tech giant Google is trying out the telehealth waters with a video-based platform that connects consumers searching online for health data with physicians.

It's almost game day for the second season of ACA insurance exchanges, and insurers need to get ready to handle all sorts of consumer inquiries and administrative tasks.

The competitiveness of America's state and regional health insurance markets is once again under question as patients and providers demand greater value propositions from payers.

A new molecular diagnostic approved by Medicare and Medicaid is among the first non-invasive alternatives to colonoscopies, a potential boon for patients and payers but also a new piece of the personalization puzzle to manage.

Cost-sharing in traditional Medicare is on the rise, and benefit designs in Medicare drug plans are changing.

As more providers adpot robotic surgery technology, more information on comparative effectiveness is raising questions about costs and benefits.