Reimbursement

Among the many challenges in year two of federal exchanges, the process of auto re-enrollment is bringing the potential of convenience and disruption, for both consumers and insurers.

As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.

Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.

Medicare's Hospital Insurance Trust Fund won't run out of money until 2030. That's four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.

A Pennsylvania provider is suing a health insurance company for passing on its 2 percent reimbursement cut required by sequestration.

Insurers trying to ride the wave of private exchanges need to be careful not to get swept up or knocked overboard amid varying business models and high customer expectations.

Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.

When it comes to speeding up the revenue cycle, the hospital pharmacy has its own part to play.

With new incentives, hospitals are increasingly making the reduction of complications, infections and readmissions a priority, but there are still infrastructure gaps that can tangle payer-provider collaboration.

While some state exchange executives exited their exchanges amid foundering technology and low public esteem, the director of one successful state HIX has landed in the growing private exchange unit of a large national insurer.