Reimbursement

Network adequacy concerns are starting to generate renewed interest in new health plan provider mandates.

The parallels between the nation's ICD-10 switch and the popular fantasy epic are real.

Advances in molecular and genomic technology are creating a maze of new options for payers and patients replete with quite a few meaningful improvements as well as some dead ends.

Home health agencies can help hospitals reduce readmissions and control overall healthcare costs, according to a new study, but how effective these agencies are in meeting such goals largely depends on the quality of organizational support given to healthcare field workers.

The ranks of Medicaid are reaching record levels, giving payers and providers, especially, new opportunities.

The backlash against narrow networks continues, as more displeased individual health consumers take their grievances to the courts of law and public opinion.

In bundled payments, where once there was so much promise, there is now conflicting evidence.

Hospitals are projected to save $5.7 billion this year as previously uninsured patients gain coverage through the 2010 health care law, the Department of Health and Human Services said Wednesday.

The ranks of Medicaid keep growing, and at record levels. But while that's good news for hospital systems' uncompensated care budgets, there are still challenges.

Conformity with CMS compliance guidance requires highly efficient communication and effective collaboration between a number of operative departments throughout a health plan.