Reimbursement

In the quest for population health, lifestyle interventions for diabetes may pose the biggest rewards and most vexing challenges. Some are making progress, however.

The Centers for Medicare and Medicaid Services late last week released the 2015 Physician Fee Schedule final rule, and it brings a number of changes that doctors and practice managers need to understand about chronic care management, the Medicare conversion factor and other key reimbursement issues.

Already big and still growing, the U.S. healthcare system in 2015 will be scrutinized inside and out for signs of financial problems, the federal government's health investigator promises.

Open enrollment is right around the corner, but where are the shoppers?

Looking out at the transition to retail insurance and inward to its own efforts to develop consumer-focused services and technology, Aetna is investing in its own private benefits exchange. 

What happens when the WGU, "World's Greatest University," as Harvard is affectionately known around Boston, decides to redesign its faculty and employee health benefits plan?

All HIPAA-covered health organizations, and especially insurers, have been handed a small victory in the war of administrative simplification, as federal regulators once again back off a policy change long in the making.

The CY 2015 final rule for the home health prospective payment system updates Medicare payment rates to home health agencies, and implements the second year of the four-year phase in of the rebasing of the payment system.

Embracing consumer-oriented healthcare, some providers are voluntarily adopting price transparency, while some insurers balk at proposed mandates to disclose their rates.

For now at least, the employer mandate isn't going anywhere. But small businesses are flocking to a new market, leaving behind traditional models.