Reimbursement
In case anyone was wondering, the RACs haven't gone away for good. They're just taking a vacation. The Centers for Medicare & Medicaid Services announced a "pause" in RAC audits last month, in preparation for the procurement of the next round of RAC contracts.
The parent company of some of the country's largest Blues plans appears to be shoring up cash reserves for what may one of the most unpredictable years in its history.
Benefits consulting firms that made early forays into private insurance exchanges are likely to be rewarded for their prescience, although the competition is growing.
The Obama Administration released its proposed federal budget for fiscal year 2015 this week. Virtually all types of healthcare providers, health plans, and drug manufacturers would be impacted by the budget provisions if adopted as proposed - although that is an unlikely scenario.
Critical access hospitals in five states are facing a spring deadline to apply for participation in a federal program aiming to develop and test new models of integrated, coordinated healthcare in rural communities.
The Centers for Medicare & Medicaid Services has a lot of data on Medicare Advantage plans that it should be using to inform policy and make available to the public, according to a new Inspector General report.
Aetna is partnering with one of the largest medical device makers in an experiment for struggling diabetic members and their doctors.
Colorado is moving ahead with an experiment for Medicare-Medicaid eligible beneficiaries, or "dual-eligibles," using a payment system many others are trying to abandon. But the state's approach incorporates a variation on the concept of the accountable care organization that's showing promise elsewhere.
With the wellness movement reaching ever more workers, more advanced digital health and wearable technologies are going to be a necessity if the field is going to evolve and start making inroads, some argue.
While most of the new individual health plans are being purchased through public insurance exchanges with tax credits, many consumers are also turning to private exchanges.