Reimbursement
An unusual 90-day grace period for government-subsidized health plans may leave physicians at risk for not getting paid for their services.
The largest national dual eligible demonstration project is taking a belated start in California, amid concerns from patient advocates. The concern surrounding the project indicates that new managed care plans have a long way to go, both in fixing problems in the system and getting buy-in from beneficiaries.
As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.
As Oregon transforms how it delivers care to 780,000 Medicaid patients, it hopes to generate better outcomes at lower costs. The problem is these goals conflict with hospital's traditional reliance on revenue from ER visits and inpatient stays.
Federal regulators are starting to finalize simmering ideas for public exchanges and also responding to consumer concerns, outlining a new quality rating system and proposals covering everything from narrow networks to loss ratios.
The days of cryptic invoicing are coming to an end for healthcare, or at it least they should be, financial experts say.
The Medicaid and CHIP Payment and Access Commission is out with its biannual report, proposing a number of changes to eligibility, premiums and disclosure policies, including some intertwining with exchange health plans.
Several months of sustained legislative progress on physician payment reform has been stopped in its tracks by an add-on.
As Montana's Blue Cross company evolves under a new corporate parent, state regulators are penalizing it for some alleged past misdeeds uncovered by an audit.
Anthem Blue Cross and Blue Shield in Colorado has convinced one-third of the state's primary care providers to join its value-based payment program, part of a wave of alternative reimbursements WellPoint is trying to spread across the country.