Reimbursement

It's a chilling reality often overlooked in annual mortality statistics: Preventable medical errors persist as the number three killer in the U.S. and the source of great waste.

After taking losses of $40 million over three years, BlueCross BlueShield of Western New York is withdrawing from the Empire State's Medicaid managed care program in six of its eight counties of operations.

Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.

More and more, health insurance professionals who design consumer-driven and high deductible plans are using them personally, a trend that bodes well for their improvement.

Hospitals participating in Independence Blue Cross' accountable care contracts are reducing costs, improving care and earning incentives, according to the Philadelphia-based insurer.

Premiums for exchange plans in many states are set to increase anywhere from slightly to significantly, but there's new competitive pressure coming as the nation's largest insurer starts flooding markets.

After one of its worst years ever, one Blue Cross company is banking on an insider and native son to lead a comeback.

Business has a vital concern in the financing of healthcare. So why is there not an outcry to switch to a proven financing system that would serve their employees well?

In a region dominated by one insurer and teeming with health systems, accountable care models are gaining provider acceptance but still accumulating evidence.

Though the deadline for complying with significant reforms of the Affordable Care Act has come and gone, payer organizations across the country are still adapting to the newfound complexities of their evolving industry.