Reimbursement

Connecting CFOs and clinicians on population health initiatives involves understanding how each group's environment influences decision-making.

While the new health insurance market is about as profitable as the pre-reform era for some large insurers, that is not the case for those like Assurant.

When CDC director Tom Frieden, MD, stated that neuraminidase inhibitors (NIs), such as Tamiflu, should be given to all elderly people with upper respiratory infection symptoms even before they have flu, I was appalled. Having read the Cochrane Review report on NIs, it seemed clear to me that at best Tamiflu was ineffective, and at worst it could cause more harm than good.

The industry has changed. What were strengths are now limitations, and new critical success factors have emerged. The status quo may be the path to extinction.

In January, the Department of Health and Human Services set a goal for 50 percent of all Medicare provider payments to be the result of value-based compensation models by 2018.

South Carolina might be an unlikely place from which to run a small healthcare empire, but the state's oldest health insurance company is doing just that.

Corporate wellness skeptics are out early this year, arguing that the data is squarely on their side and that simpler, laissez faire approaches could be more effective.

Salinas, California topped spending for all three procedures: $60,375 for a coronary stent placement; $57,990 for a total hip replacement; and $25,924 for a laparoscopic appendectomy.

Once again, insurance practices on cost-sharing and reimbursement for out-of-network providers and PPOs are ending up in dispute, with backlash from providers and customers.

An estimated $22 billion in healthcare spending would be lost due to those losing coverage under the Affordable Care Act, according to a new report by the Urban Institute of the Robert Wood Johnson Foundation.