Reimbursement

Health Plan Alliance (HAP) along with Cardinal Health Specialty Solutions and oncology consulting firm Physician Resource Management have announced they will work together to launch in Michigan an evidence-based clinical pathways program that is intended to improve the quality and lower the costs of cancer treatment.

Twelve Iowa cities and towns are applying to be demonstration sites for the Blue Zones project, a micro-level experiment in trying to improve health and well-being by Healthways and with funding assistance from health insurer Wellmark.

Most employers that measure the performance of their employee wellness and value-based healthcare offerings show a return on investment (ROI) for these programs, with a significant number showing savings of $3 or more for every dollar spent, according to new research published by the International Foundation of Employee Benefit Plans (IFEBP).

New York Downtown Hospital will pay a total of $13.4 million in a Medicare and Medicaid fraud settlement that alleged the hospital received claims on an unlicensed inpatient drug detox program and that it paid kickbacks to an out-of-state vendor for referrals to the program.

After the Centers for Medicare & Medicaid Services denied Maine an expedited review for its $20 million Medicaid reduction plans, the state's attorney general is seeking a federal court review to prompt a decision.

With HHS issuing a final rule that establishes Oct. 1, 2014 as the ICD-10 compliance deadline, physicians and medical personnel are girding themselves for what many officials perceive to be a complex labyrinth of documentation.

Nearly every healthcare organization and affiliated clinician group faces challenges when working to meet new models of care and payment delivery. One industry expert offers six pieces of advice to lower costs, improve care and maximize revenue in the ED.

Even as many states gear up for tougher insurance regulations under the federal health law, Maine lawmakers last year bucked the trend, loosening rules they blamed for some of the highest premiums in the nation.

As care models spring up across the country to test whether patient-centered, accountable care can save money and improve health outcomes, a payer-provider collaboration in Portland, Maine is demonstrating that at least theirs holds promise.

According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.