Reimbursement

Following the nation's changing demographics at the local level in some major markets, Humana is making a small investment in more convenient service for Hispanic and Latino members.

Clearly healthcare is the most interesting and dynamic sector in the U.S. today. We are witness to an unprecedented transformation as healthcare stakeholders embrace new delivery entities and new reimbursement models, shift attention to building relationships with members and explore new markets. There will be winners and losers in this game, and everyone is placing their bets.

Some state health insurance markets are in for another exodus of pre-health reform plans, as regulators pursue stability on and off the public exchanges.

Unless Congress takes action by the end of this month, doctors who treat Medicare patients will see a 21 percent payment cut.

Vague statement by Joint Committee claims lawmakers are working on a replacement, though no details are released.

Despite a proliferation of digital health companies, payers, providers and patients have many unmet needs. The Pacific Northwest's oldest insurer is trying to help find new ideas, outside the industry.

If Congress doesn’t act, starting on April 1, physicians who accept Medicare would get a 21.2 percent pay cut.

With two-thirds of Massachusetts healthcare still paid via fee-for-service, the state's largest insurer wants to ply its HMO-grown variety of accountable care in PPOs. It's sure to challenge providers.

Too many consumers have learned the hard way that their credit rating can be tarnished by medical bills they may not owe or when disputes delay insurer payment.

Exchange market leaders in 2014 may have had a large portion of their membership renew coverage, but a material portion may have higher monthly costs in 2015, which could change persistency rates.