Reimbursement
Transparency mandates make it tricky for health systems, as a procedure’s cost and what patients pay is very different.
While reimbursement is still being determined, it’s estimated that lung cancer scans for eligible individuals could cost Medicare more than $9 billion for the scans, biopsies and treatments through 2020.
Armstrong v. the Exceptional Child Center Inc. ruling is a blow to healthcare providers who say they are losing money in seeing patients covered by Medicaid due to inadequate reimbursement.
Are exchange insurers failing to adequately cover mandated tobacco cessation at no cost-sharing, or just not explicitly highlighting the benefits?
Across the Mississippi River from a bankrupt cousin, a Midwestern cooperative insurer is entering year two with a sizable membership that will test its model of partnering with hospitals.
Health insurers in New Jersey are complaining of a cost crisis arising from regulations meant to protect patients receiving emergency healthcare and involuntary out-of-network treatment.
We don't need to put more emphasis on the penalties for not buying health plans; we need attractive insurance products people want to buy.
Medicare spent $4.5 billion last year on new, pricey medications that cure the liver disease hepatitis C, more than 15 times what it spent the year before on older treatments for the disease.
America's largest insurer is looking for all the scale it can get in the war for affordable medicines.
Catamaran serves about 25 million Americans with retail pharmacy network management, mail-order pharmacy, pharmacy claims management and patient-centric specialty pharmacy services to health plans and employers.