Reimbursement

As many as 31 million Americans now receive healthcare through an accountable care organization (ACO) according to a recent report from industry consulting company Oliver Wyman.

Insurance coverage for tobacco cessation varies widely and is often explained in convoluted and occasionally contradictory contract language, a study of 39 health plans has found.

Healthcare reform is fundamentally changing the way hospitals are run. A combination of crushing costs, government edicts and fierce competition for the millions of newly insured patients that will result from federal healthcare legislation is putting the patient front and center.

A new report from the Government Accountability Office (GAO) found that less than 4 percent of Medicaid beneficiaries who had coverage for at least a year reported difficulty obtaining medical care in 2008 and 2009, this despite more than two-thirds of states reporting they faced challenges in ensuring there are enough Medicaid providers to serve the growing number of beneficiaries.

With the implementation of a grant-funded program to reduce hospital readmissions for elderly patients with heart failure, the University of California, San Francisco (UCSF) Medical Center was able to reduce rates of heart failure readmissions over a two-year period by 46 percent within 30 days of hospital discharge and by 35 percent within 90 days.

Florida to make higher Medicaid payments; coalition urges Texas legislature to fully fund Medicaid program; and Conn. officials surprised by Medicaid enrollee growth in this week's Medicaid Digest.

Michigan lawmakers are transitioning Blue Cross Blue Shield of Michigan into a member-owned nonprofit, as the organization's historic mission as a tax-exempt "insurer of last resort" becomes unnecessary under the Affordable Care Act.

Nearly a year after providing guidance that broadly defined essential health benefits (EHBs), the U.S. Department of Health and Human Services on Tuesday put some meat on the bones with a detailed set of proposed rules that will determine the required components that must be offered beginning in 2014 through all non-grandfathered health plans.

Nearly a year after providing guidance that broadly defined essential health benefits (EHBs), the U.S. Department of Health and Human Services on Tuesday put some meat on the bones with a detailed set of proposed rules that will determine the required components that must be offered beginning in 2014 through all non-grandfathered health plans.

In an effort to control costs and get people covered by health insurance, the Affordable Care Act offers a number of options for covering low-income people. Among those options is the Basic Health Program, which some say will save money and others say will kill health insurance exchanges.