Reimbursement

Rural health providers may feel burdened by a confluence of policy and financing trends. But one opportunity, depending on the state, can help with sustainability.

Health plans, providers and legislators need to increase the number of primary care practitioners participating in Medicaid as the wait for many to access care is inadequate and getting worse as enrollment mushrooms.

Drug benefits stand as some of the most consequential consumer confusions that can arise in public exchanges, increasing the onus on insurers to improve the design and explanation of formularies.

CVS recently made the bold move of quitting tobacco as part of its retail health ambitions. Now, a chief rival is upping the bet, trying to target consumer incentives and enter a wellness market in flux.

Another health system is taking a step into insurance with Medicare Advantage, banking on seniors wanting access to a prestigious brand.

Medicare is fining a record number of hospitals -- 2,610 -- for having too many patients return within a month for additional treatments, federal records released Oct. 1 show. Thirty-nine of those are receiving the largest penalty allowed.

A new report by the Virginia Hospital and Healthcare Association paints a grim picture of the daunting financial challenges facing hospitals and other healthcare organizations in that state.

With one year left, it's time to chart your map to the new code set. And given that so many payers and providers are lagging behind recommended timelines, these tactics will help you get organized.

More and more insurers are getting on to the smartphone and mobile health wave, trying to both attract tech-savvy members and try out new wellness ideas.

Healthcare systems have used value analysis for years but the practice is gaining renewed attention as reimbursement pressures continue rising.