Reimbursement
The Centers for Medicare & Medicaid Services (CMS) recently released its model documents for the 2015 Annual Enrollment Period (AEP). The rigorous, highly complex rules and regulations for member marketing materials wreak havoc on health plans year after year. The clock is now ticking.
As new generations age, with some 10,000 Americans expected to turn 65 every day over the next 15 years, the ability to extend life is increasing. But a logistical conversation about death is one that families, couples and policymakers can't avoid.
Much-loved by a key consumer demographic and highly-guarded by its corporate parent, Trader Joe's has pioneered affordable, great quality groceries. Can its model work in America's healthcare system?
As Medicaid enrollment grows to record levels, covering 65 million people nationwide, providers are starting to see some positive trends in their rates of uncompensated care, as managed care organizations garner new membership.
Hospitals in states that have expanded Medicaid eligibility under the Affordable Care Act are already bringing in fewer self-pay and charity care patient cases, according to an analysis by the Colorado Hospital Association.
As providers continue adjusting to the reimbursement changes wrought by the Affordable Care Act, it appears increasingly likely that hospitals will place more emphasis on collecting payments at the point of service.
As a once-promising tax scheme to maximize federal Medicaid dollars fades from practicality, budget woes are coming to the fore and creating an impetus for program redesigns.
Not one year into New Hampshire's Medicaid managed care expansion, one physician-operated health plan is deciding to redirect its resources elsewhere, leaving other plans with new responsibilities.
Florida's largest insurer is humming along with its strategy of alternative reimbursement models, signing an accountable care agreement with one of Tenet's ACO networks.
Bariatric surgery has experienced a 16-fold growth in the U.S. within the last 15 years. Reimbursement for gastric band placement and gastric band removal/replacement -- the main types of bariatric procedures -- will increase by 4.5 percent and 6.8 percent respectively in 2014.