Reimbursement

Access to prices and just a bit of nudging seems to not only help members find the best deals on elective health services like imaging but also spur some competition among providers.

At a time when states are both reforming Medicaid and expanding managed care, insurers have a lot of opportunities to grow business and increase value, but also many challenges.

Last month the Centers for Medicare & Medicaid Services published its proposed rule to update the Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System rates and policies for calendar year 2015. Here's what you need to know.

Startups and investors from Silicon Valley to the Charles River are chasing after the next paradigm-shifting blockbuster innovation. But are any of new companies developing technology that will truly help transform healthcare?

Two large health insurers are hoping a new "public utility" patient data sharing service will improve one of the most pernicious problems in American healthcare.

A venture by Independence Blue Cross and a company ranking well in Warren Buffett's portfolio is getting underway, in an ambitious attempt to optimize the benefits of primary care.

One of the largest Medicaid managed care expansions has been given the green light for what will be a test of reducing public-payer spending.

As provider power grows and integrated healthcare becomes a central goal, the time may become ripe for more payer takeovers of a kind not seen before.

Premiums for exchange plans in California are looking pretty affordable. Is this because insurers are fearful of a rate review process that might be approved by voters in the fall, or a large, diverse market spreading out risk?

Well, here we are. The revised compliance date for providers, payers and clearinghouses to transition to ICD-10 has been finalized by the Department of Health and Human Services.