Reimbursement

Ambulatory surgery centers have new evidence to back up arguments for its relative cost-effectiveness.

As health plans start serving newly-insured populations and try to improve outcomes for long-time patients, all while taking on more financial risk, the case for aggressively targeting diabetes and obesity has never been greater.

The ambulatory surgery center movement has some evidence to back up arguments for its relative cost-effectiveness, although variation can still be vexing for health plans and patients.

The nation's diabetes and obesity crises have started taking their toll on healthcare spending, and some insurers are stepping in before new generations develop these problems in the long-term.

Just as government marketplaces are transforming their individual policy businesses, Blue Cross and Blue Shield companies are setting up private exchanges to save a far larger source of traditional revenue.

A quarter of the nation's hospitals in October will receive lower Medicare payments because their rates of patient complications are higher than their peers. Here is an explanation of the three measures Medicare is using to calculate the hospital-acquired conditions scores.

Many questions remain on how specific details of the Affordable Care Act will be resolved, but one significant trend is clear: the shift toward risk sharing among patients, providers and insurers is well underway.

Many healthcare executives fall prey to two common misconceptions about data breaches: that the only companies making headlines for lax data security are big retailers like Target and that the biggest culprits are teenage hackers or sophisticated teams working in China or Eastern Europe.

Insurer premiums in the second year of public exchanges look financially wise to credit experts, although there are also some double-edged swords.

Even before federal approval is won for the experimental program, insurers in one large state are ready to start selling exchange plans to Medicaid beneficiaries.