Reimbursement
A short-lived network dispute has come to a resolution. But that doesn't mean the points of contention are going away.
One of the most fractious hospital acquisition disputes in the country has come back to square one, in a potential win for payers and antitrust advocates.
A move last year by Urology of Greater Atlanta to collect payments up front and establish an e-billing automatic payment plan has resulted in fewer surgeries but greater revenue.
The ambitious new value-based healthcare coalition, including Aetna and HCSC, is wasting no time dispersing ideas. Consensus on reform may be difficult, and the work ahead even more so.
What's up with the Health Care Transformation Task Force? In the midst of all the excitement, there are very few thoughtful observers who raise questions about the march.
When Ken Fasola was working at Humana and UnitedHealth Group in the 1990s and 2000s, the industry saw individual insurance products as "the bottom end of the food chain."
Insurers have to improve consumer education about drug formularies in exchanges, at the least, and some may even have to change their practices to meet new health reform standards.
Humana and DaVita are joining forces to try out a new way to serve high risk, special needs patients with a primary care-led model.
Indiana is pushing the bounds of Medicaid with the first-ever consumer-driven health plan for low-income populations. It's opening up new possibilities for other right-leaning states, but testing federal limits.
Health Care Transformation Task Force says 75 percent of the members will convert by 2020 as Medicare plans to tie 50 percent of payments to quality by 2018.