Reimbursement

Medicare Advantage members in Pennsylvania who enrolled in a Health Quality Partners (HQP) care management program had 20 percent fewer inpatient hospital admissions, according to a report issued by Aetna on Nov. 16.

The three pillars of what's often dubbed Newt Inc. -- two for-profit groups and one defunct political committee -- raked in more than $105 million in revenue and donations from 2001 through 2010 while Newt Gingrich was eyeing a political comeback.

Health plans looking to change member behavior to produce better health outcomes need to take a multivariable approach to member engagement.

The Centers for Medicare and Medicaid Services has its work cut out in transitioning to ICD-10. As the largest payer and the force driving the new code sets in the United States, CMS has a task at least as intimidating as anyone else in implementing ICD-10.

In an effort to provide some sense of certainty about an ACO's ability to reach the so-called triple aim of reducing cost, improving quality and enhancing patient experience, the National Committee for Quality Assurance (NCQA) released on Monday its standards and guidelines which are the basis of its ACO accreditation program.

A new analysis by the Medical Imaging & Technology Alliance (MITA) finds that Medicare spending on medical imaging continues to decline, and that Medicare patients are receiving fewer imaging procedures.

Electronic health records will become the norm, sooner than later, experts said at a summit hosted by the Office of the National Coordinator for Health IT (ONC).

Aetna and Banner Health Network will create an accountable care organization made up of Banner employed and affiliated physicians and hospitals in Arizona. The ACO will employ information technology and a team-based approach to care for patients.