Reimbursement
As a payer and provider and the country's largest managed care organization with a lot of digital and online patient data, Kaiser Permanente has tried to address privacy and security head-on, and may pave a way for others.
As part of a contract extension with Tenet Healthcare, Cigna has established a first of its kind quality-based reimbursement agreement.
The corporate saga of a Medicaid managed care fraud case is coming to a close as three former executives head to federal prison, offering a cautionary tale for public benefits contracting.
Just in time for plan application and premium rating season, federal regulators have finalized market policies for the ACA's second open enrollment period, while continuing the tradition of leaving a few important issues to-be-determined.
If global spending becomes the norm in Medicaid, health systems, medical practices, home health and community organizations will face an even greater impetus to collaborate. In the Empire State, some are already starting the journey.
Last week, the Centers for Medicare & Medicaid Services published a final rule that reforms federal health policy regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on healthcare providers and suppliers. Here are some highlights.
According to a study published this week in Health Affairs, the Great Recession did not have a permanent negative financial impact on vulnerable hospitals, such as safety net facilities, or those considered financially weak prior to the recession. However, this doesn't mean these same hospitals will fare so well in coming years.
A media specialist who shares roots with Affordable Care Act foes is taking the communications helm of AHIP, tasked with defending an industry in transition and often under scrutiny for narrow networks and premium affordability.
As an alternative to traditional eligibility expansion, one Republican hopes to bring consumer-directed insurance to Medicaid while also bridging a gap in the lower end of the group insurance market.
Although accountable care organizations are still in their nascent stages, a few large provider groups and payers may be ahead of the curve on operations and performance.