Reimbursement
So what can Massachusetts do to address their risk adjustment woes? They are taking a step in the right direction by recognizing that data quality is at the core of any corrective action.
Organizations will see higher Medicare payments when you combine their quality bonus with any readmissions or hospital-acquired conditions penalties.
With the surging costs of specialty drugs, what was once unthinkable in American healthcare is starting to look like a viable idea that the President is pushing.
President would reduce the Medicare budget by $400 billion over the next 10 years.
A regional Blue Cross insurer in the southern Midwest is turning to a long-time marketing executive to guide it into the next generation of health insurance.
New Jersey's largest insurer is expanding its medical home program in an effort to boost primary care access and member satisfaction, as new competitive threats loom from non-traditional insurers.
Aetna is positioning itself to ride out the early storms of health reform and end up plying the new waters sustainably.
Pennsylvania's largest insurer has agreed to a broader interpretation of continuity of care provisions in a long-term accord with its main rival, while also touting what it sees as positive membership choice trends.
Not everyone who could benefit from colon cancer screening is enthusiastic about receiving the invasive "gold standard" diagnostic. It can also be expensive for insurers, unlike other options for patients.
The nation's largest laboratory company and two big insurers stand accused of creating a diagnostic monopoly that hasn't passed on savings to consumers.