Reimbursement

Insurers looking to compete in the ever-changing healthcare marketplace will continue to focus on technology in 2013 both as a means of improving payment models and partnerships with provider groups and as the industry looks to make the transition to consumer-focused products it will offer on health insurance exchanges.

The Department of Health and Human Services estimates that some 25 million Americans will be buying health insurance through Affordable Care Act-certified exchanges within the next few years. But that and a lot of other HIX outcomes remain to be seen.

New research from the Employee Benefit Research Institute (EBRI) shows that employees enrolled in a Consumer Directed Health Plan (CDHP) are more likely than members of traditional health plans to exhibit cost-conscious behaviors including doing additional research on healthcare costs.

In the 166 pages of health insurance exchange rules published by the Department of Health and Human Services last March, one provision came as a pleasant surprise to some private HIX firms -- section 155.220, letting public exchanges contract with "web-based entities" to market and sell qualified health plans.

Medicare on Dec. 20 disclosed bonuses and penalties for nearly 3,000 hospitals as it ties almost $1 billion in payments to the quality of care provided to patients.

Kroll Advisory Solutions has released its 2013 Cyber Security Forecast, spotlighting some of the pressing and perhaps unexpected privacy and security issues healthcare and other organizations may be grappling with in the coming year.

After three terms in Congress and a primary loss last spring, Pennsylvania Congressman Jason Altmire is heading to Florida Blue as senior VP for government affairs, leaving one of the most fractious institutions in the country for one of the most tumultuous industries.

The Department of Health and Human Services has awarded the consumer oriented and operated plan (CO-OP) in Illinois, the Metropolitan Chicago Healthcare Council, with a $160 million loan to run the Land of Lincoln Health CO-OP.

A spokesman for Kansas Gov. Sam Brownback told the Legislature's Joint Committee on Health Policy Oversight that it will develop its own estimate of the cost of expanding Medicaid, before the state commits to the expansion as spelled out in the Affordable Care Act.

Insurer Florida Blue and the Moffitt Cancer Center on Thursday announced the creation of an accountable care program that will focus on the treatment of cancer.