Reimbursement

In the search for meaningful patient care improvements and sustainable financing, some independent physician groups are charting unique approaches that may offer models for payers and providers in the age of cost-containment and risk-sharing.

For the second year in a row, Humana ranked first in overall performance among 148 payers, according to the 2014 PayerView Report. The report ranks health insurers according to specific measures of financial, administrative and transactional performance.

States, insurers and self-funded employers are facing mounting pressure to expand autism coverage, but some may be too slow for advocates.

The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled.

One of the biggest beneficiaries of healthcare reform's expansion of insurance coverage to more than 13 million people this year has been the nation's safety-net hospitals. At least in the states that have chosen to accept the Medicaid expansion.

Amid the transition to the Affordable Care Act, startup companies looking to augment, service or replace health insurance have been getting record investments.

The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.

AmeriMark Direct started its mail order catalog business here in the 1960s, and for decades, everyone assumed that health insurance came with the job.

The Centers for Medicare and Medicaid Services has announced the first group of prospective winners of its Health Care Innovation Awards. The winners could receive receive $2 million to $18 million each over three years for trying innovative care models.

With millions of Americans on new health insurance exchange plans now responsible for high deductibles, hospitals, drug makers, insurers and regulators are entering a new frontier of payment disputes.