Reimbursement
After recovering claims from a pharmacy provider, a group of 27 states are suing Novartis, alleging the company participated in a kickback scheme to boost Medicaid sales for a controversial blood drug.
Empowered consumers, rapid innovation and increasing competition are among PwC's top issues for providers and payers and other healthcare businesses for 2014, the company announced last week during a webinar.
Now that most consumer-facing parts of HealthCare.gov are working, the biggest problem is "making sure plans get paid," the lead manager of insurance exchanges and regulations at the Centers for Medicare & Medicaid Services told federal lawmakers.
Aetna, Cigna and the Blues sprang out of the gate in just the first two weeks of the year with announcements of newly formed accountable care organizations and expansions of existing ones, adding more scale and breadth to testing of value-based models to deliver better care at lower cost.
Enrollment in Medicaid managed care is continuing its growth in tandem with eligibility expansion, bringing benefits and challenges to insurers, according to an Avalere Health analysis.
After requiring small businesses to buy insurance through the state exchange, continued website dysfunction has left Vermont health officials asking businesses to enroll directly with insurers.
Reimbursing a physician for their time spent in having end-of-life discussions is not an incentive for a "death panel" decision; it would be compensating them for doing their job. If all we do is compensate physicians for treating people aggressively regardless of the circumstances, we will get what we pay for: an expensive healthcare system run amok.
In a reversal of 30 years' past practice, Medicare may start to disclose what it pays individual physicians for its services to seniors.
In a reversal of 30 years' past practice, Medicare may start to disclose what it pays individual physicians for its services to seniors.
Hospitals have been acquiring physician practices and have been doing so for years, but a case resting in the hands of a federal judge in Boise is proving to be a "banner" case for these sorts of mergers and acquisitions.