Reimbursement

The employer wellness movement is gaining steam globally, but some trends are hitting a wall.

One state is finding new approaches to managing Medicaid frequent fliers.

Imagine trying to run a successful business when employers, competitors, and other service providers have launched focused campaigns that encourage consumers to avoid you. If you run a restaurant or an auto-repair shop, this scenario is far-fetched. If you run a hospital, it's reality.

Just in case you didn't get the memo earlier this week, hospitals should take note that the Centers for Medicare & Medicaid Services will soon allow Recovery Auditors to restart some reviews.

Federal health officials are increasingly scrutinizing Medicare Advantage risk adjustment, suggesting policy changes and even clawbacks to come.

Pretty soon, 24/7 digital access to a physician or nurse practitioner could be a standard health plan benefit.

Chief financial officers at hospitals and health systems must track a multitude of difficult financial issues these days. One question, however, always stops a conversation cold: Why are our reimbursements declining?

Walmart is taking another, bigger step into American healthcare with new primary care services. Is a health plan next?

The diabetes crisis and pay-for-value evolution are coming to a head, helping change provider reimbursement in Medicaid.

There's been a lot of talk about compliance lately. Federal and state regulations. HIPAA regulations. But, if you're in charge of healthcare security, compliance is far from sufficient, according to one large insurer.