Reimbursement

Insurers selling public exchange plans last year faced a lot of uncertainty. This year it's a bit better, but the plans remain a product design experiment with confounding variables in an environment much in flux.

The value-based reimbursement model predicted by many to dominate the reimbursement market is also the one they say will be hardest to implement.

If your state is building a health insurance exchange, or you hope it ultimately will, the experience of Washington, Kentucky and Minnesota can help.

To some, many of the new bronze-level health plans sold in public exchanges are de facto catastrophic plans. Others say, "Not so," as young people especially need more low-premium plans.

In the new era of individual consumer-based health insurance, insurers have to earn the trust of Americans if they want to address the costly chronic disease burden.

Medicare's ACOs have had mixed early outcomes, but some commercial accountable care ventures, including PPO plans, are showing promise.

While Medicare's ACOs have had mixed early outcomes, some young commercial accountable care ventures, including PPO plans, are showing promise.

The boom in employer self-funding is coming along with many more catastrophic claims, raising concerns for insurers bundling third-party administrative services and stop-loss coverage.

Healthcare reform and the shift toward value instead of volume underscore the importance of population health management for improving patient outcomes on a large scale. One essential component of a comprehensive population health program is patient access.

States are making a bold move toward healthcare transparency, betting that easily-available hospital data will empower consumers and drive quality changes.