Reimbursement

The Congressional Budget Office has revised its estimates of the Affordable Care Act's costs, with results favorable to the Treasury. However, it also now predicts more premium and network turmoil.

Highmark sees a market for guiding the millions of American adults helping their aging and ill parents, relatives and friends.

When it comes to security threat severity, the Heartbleed bug doesn't miss a beat, and may not for some time.

As payers on behalf of states and the federal government, Medicaid managed care organizations have the potential to drive reforms, and if they don't, they could be on the chopping block.

The Affordable Care Act, ICD-10 compliance and the growth of retail healthcare are just a few of the realities payer CIOs now deal with. They are also reasons why features like open architecture and consumer accessibility are much-needed.

Centers for Medicare & Medicaid Services leaders point to seniors' wide array of Medicare Advantage and Part D choices as evidence of the program's and insurer's health, but regulators may soon be terminating dozens of plans, unless sponsors pull out first.

Sometimes the best solution is the simplest one. That's what some payers are finding out, for instance, with a home monitoring solution that tracks activity, rather than vital signs, for seniors and their caregivers.

Many startups and companies from other industries have physicians, hospitals, insurers and medtech manufacturers in their sights, betting that they can offer better services at cheaper prices for dissatisfied consumers.

Stuck with exchange software too flawed to fix, Maryland Health Connection leaders are choosing a novel solution that paves the way for other beleaguered state exchanges to seek help from their better performing peers.

The market for commercial full-risk insurance is slowly declining amid the rise of self-insurance, but a few large nationals, the Blues and some integrated care plans are still seeing healthy business.