Reimbursement

To get ready to participate in integrated care funded by bundled payments, behavioral health providers need to establish a new business model, with particular emphasis on establishing episode of care rates.

New York has got a federal OK to take $8 billion in Medicaid savings to experiment with some ambitious delivery and payment reforms that build off of, but may upend, its managed care system.

Even with some 15 million Americans covered by high-deductible health plans, health organizations are "not prepared to meet consumer payment expectations," according to the fourth annual payment trends report by InstaMed, a Philadelphia-based payment network company.

After finding one state shifting millions in Medicare-Medicaid dual eligible costs to the feds, Medicare's watchdog suspects more may be doing the same.

The Congressional Budget Office has revised its estimates of the Affordable Care Act's costs, with results favorable to the Treasury. However, it also now predicts more premium and network turmoil.

Highmark sees a market for guiding the millions of American adults helping their aging and ill parents, relatives and friends.

When it comes to security threat severity, the Heartbleed bug doesn't miss a beat, and may not for some time.

As payers on behalf of states and the federal government, Medicaid managed care organizations have the potential to drive reforms, and if they don't, they could be on the chopping block.

Centers for Medicare & Medicaid Services leaders point to seniors' wide array of Medicare Advantage and Part D choices as evidence of the program's and insurer's health, but regulators may soon be terminating dozens of plans, unless sponsors pull out first.

Sometimes the best solution is the simplest one. That's what some payers are finding out, for instance, with a home monitoring solution that tracks activity, rather than vital signs, for seniors and their caregivers.