Reimbursement

After the botched rollout of insurance exchanges last year, the federal government is trying to get the technology right for what promises to be just as big a consumer turnout this fall.

A quarter of the nation's hospitals, those with the worst rates of hospital-acquired conditions, will lose 1 percent of every Medicare payment for a year starting in October. The sanctions, estimated to total $330 million over a year, kick in at a time when most infections measured in hospitals are on the decline, but still too common.

A new start-up is hoping to become the largest enabler of primary care in the country within six years, by letting independent docs start ACO networks and stay free of the hassle of hospital systems and payers.

Aetna is extending its ACO network and health plan offerings in America's heartland, trying to meet promises of bringing accountable care to the commercially-insured masses in competition with United and WellPoint.

Any day now, the Supreme Court will issue its decision on the "contraception mandate" and could add more complexity to health plan administration, while another dispute may spell even more trouble.

As ObamaCare launched last fall you'll recall 16 states started their own exchanges. 

Insurers that have submitted applications to sell exchange plans are currently waiting, hoping regulators will approve their premiums and that consumers will find them affordable, in what will be a more crowded marketplace.

The state of Illinois is nailing down key Medicaid policies ahead of a massive managed care rollout and accountable care experiment.

WellPoint has won the right to challenge a hospital's chargemaster billing practices, but the ultimate resolution could still disrupt relations with a key provider in a large market.

MedPAC is out with its 15th annual mid-year report, offering advice for Congress and the Department of Health and Human Services to improve and sustain the senior's health program as it enrolls millions of retiring baby boomers. Here's what hospitals need to know about the commission's latest thinking.