Reimbursement

With millions of Americans joining the ranks of those with health insurance under the Affordable Care Act, payers need to become even more vigilant in controlling costs.

The booming Medicaid managed care industry is in for new federal regulations and consolidation, presenting challenges and opportunities for health systems.

Medicare turns 50 years old this month and has recently given a nicely wrapped present to advocates for more healthcare dollar value: a better way to pay for hip and knee replacements in the form of bundled payments.

New law prohibits insurers -- when they cover other types of fertility treatments -- from applying those conditions to same-sex couples.

Population health brought evidence-based medicine to the family doctor's office, vastly improving the overall quality and consistency of care in this country, but in doing so, it forgot about the individuals who make up the population.

Few days went by last year when New Hampshire nephrologist Ana Stankovic didn't receive a payment from a drug company.

Maryland same-sex couples who wanted to take advantage of a state law that requires insurers to cover pricey in vitro fertilization treatments used to face insurmountable obstacles. Not anymore.

A Michigan hematologist will likely spend the rest of his life in prison after defrauding Medicare and private insurers, and violating the first tenet of medicine, "Do no harm."

North Dakota's largest health insurer has made a quick turnaround after a year of underwriting losses and lost technology contracts.

James Colbert, MD, Harvard medical instructor and ACO Learning Network consultant, on the challenges and opportunities of designing high value networks and the data needed to do it.