Reimbursement

Hospitals are increasingly making reducing hospital-acquired infections and readmissions a priority -- and saving millions of dollars in the process -- but there are still gaps to be filled.

The diabetes and obesity epidemics mean more Americans may suffer from heart disease before they turn 65, challenging payers to craft better intervention models that help prevent serious cardiovascular events and increased spending on acute care.

It's a chilling reality often overlooked in annual mortality statistics: Preventable medical errors persist as the number three killer in the U.S. and the source of great waste.

After taking losses of $40 million over three years, BlueCross BlueShield of Western New York is withdrawing from the Empire State's Medicaid managed care program in six of its eight counties of operations.

Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.

More and more, health insurance professionals who design consumer-driven and high deductible plans are using them personally, a trend that bodes well for their improvement.

Hospitals participating in Independence Blue Cross' accountable care contracts are reducing costs, improving care and earning incentives, according to the Philadelphia-based insurer.

Premiums for exchange plans in many states are set to increase anywhere from slightly to significantly, but there's new competitive pressure coming as the nation's largest insurer starts flooding markets.

After one of its worst years ever, one Blue Cross company is banking on an insider and native son to lead a comeback.

In a region dominated by one insurer and teeming with health systems, accountable care models are gaining provider acceptance but still accumulating evidence.