Reimbursement

Behavior change is critical to better outcomes, for patients, as well as providers and payers, as one health system with an insurance arm is finding.

The Obama administration is boasting that 8 million Americans, including a good number of young people, have enrolled in public exchange plans. The big question now is how will new members fit into the risk adjustment puzzle?

For the first time in almost four years, WellPoint will have a chief strategy officer, just as value-based reimbursement contracts are taking off.

The Healthcare Financial Management Association's new Price Transparency Task Force has released recommendations for how health plans and providers should inform patients on estimated prices, out-of-pocket costs, in-network status and value.

The nation's largest insurer lead off the first financial quarter under the full Affordable Care Act with a blend of optimism for growth and pragmatism for confronting headwinds like Medicare Advantage and specialty drug costs.

How the small employer market has a lot to gain by from private exchanges.

To get ready to participate in integrated care funded by bundled payments, behavioral health providers need to establish a new business model, with particular emphasis on establishing episode of care rates.

New York has got a federal OK to take $8 billion in Medicaid savings to experiment with some ambitious delivery and payment reforms that build off of, but may upend, its managed care system.

Even with some 15 million Americans covered by high-deductible health plans, health organizations are "not prepared to meet consumer payment expectations," according to the fourth annual payment trends report by InstaMed, a Philadelphia-based payment network company.

After finding one state shifting millions in Medicare-Medicaid dual eligible costs to the feds, Medicare's watchdog suspects more may be doing the same.