Reimbursement

There is a fair amount of hope for private health insurance exchanges in the commercial group market, but a pure defined contribution option will actually require a quite disruptive change.

After holding an overnight vote-a-rama session well into Friday morning, the U.S. Senate decided to delay voting on the sustainable growth rate repeal until after its recess.

American employers are spending more on wellness programs than ever, but also backing away from penalties, as consumers respond with skepticism and researchers keep probing ROI evidence.

Cigna is looking for business in younger, yet-to-retire baby boomers in California, anticipating the benefits of streamlining the path from group health plan to Medicare Advantage.

Outpatient payments for cancer hospitals were 37 percent higher than teaching hospitals for the same range of services, report finds.

Amid a possible bipartisan break in the clouds of Congress, insurance advocates see a window for changing or even repealing the much-loathed health insurance tax in the Affordable Care Act.

Former owners of California medical device companies of submitted fraudulent claims to Medicare for power wheelchairs and other equipment totaling $6.8 million.

Cost of repealing Medicare's sustainable growth rate would add $145 billion in government spending, report claims.

In my close look at silver plan selection in 2015 among HealthCare.gov customers who were eligible for Cost Sharing Reduction (available only with silver plans), I expressed some disappointment that CSR takeup had apparently dipped a bit on the federal exchange from 2014 to 2015. Disappointment on that particular point may have been misplaced.

“Not all readmissions can or should be prevented; indeed, some are planned as part of sound clinical care,” AHA says.