Reimbursement

Many health plans are looking for ways to maximize their performance in the new year. Payment integrity can help plans and other healthcare organizations operate more efficiently. But where to begin?  

Workers at Seattle's largest employer are signing up in droves for new ACO health plans led by regional health systems, who see the model as ripe for growth.

The U.S. Department of Defense can look like a benefits company "that occasionally kills a terrorist." The agency has to overhaul its healthcare contracting, especially TRICARE, according to advocates.

"Credit monitoring for a breach of your identity data, medical or not, is like handing out umbrellas in a tornado." This is a fitting analogy, as healthcare is amidst a converging storm of cyber security; four forces fairly unique to other industries seem to plague the healthcare ecosystem at a confluence.

The Minnesota-based insurer expects to partner with up to 250 new ACOs this year.

The nation's largest insurer is making leaps in the journey of consumer-driven healthcare, improving its digital offerings and investing in new member incentives.

"Is this doctor in my insurance network?" is part of the litany of questions asked when considering whether to see a particular doctor. Unfortunately, the answer may not be a simple yes or no.

After decades of research showing at best mixed benefits, certificate of need programs are starting to look antiquated and deleterious in the age of consumer-driven healthcare.

Whether or not more co-ops falter, many insurers could learn from some of their goals and experiments, including in primary care.

Hospitals also saw a 55 percent reduction in uncompensated care visits in the first three quarters of 2014.