Reimbursement
Consumer advocates and an activist insurance commissioner in California are renewing a push for premium review authority, while the state exchange is moving ahead with its own version of active purchasing.
The problem is that sometimes Medicare pays for care outside the hospice benefit that it already paid hospice to cover.
For Humana, the national insurer with the most Medicare Advantage members, retail health clinics are out of the integration strategy, but home care is very much in.
Illinois' largest health insurer is building out its accountable care network, even as some of the health system partners are consolidating.
Centers for Medicare and Medicaid Services plans to keep program in place that penalizes hospitals that showed too many medical errors.
Taking a cue from car manufacturers and cell phone companies, some providers are starting to see value in guaranteeing a standard for quality and costs.
Despite the government's push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices.
In a new oncology program in Florida, Aetna is trying to combine the medical home model with access to advanced care and translational research.
What does managed care even mean these days? As the field has ballooned, its substance has been diluted, though it will still be useful in the new healthcare economy.
Centers for Medicare and Medicaid Services said it expects to include further discussion of the issue in the 2016 prospective payment systems proposal to be published this summer.