Reimbursement
The growth of generic drugs has been a good news story for payers and pharmaceutical benefit managers (PBMs), but that story may be coming to an end.
With the growing complexity and unpredictability of reimbursement, the existing back-end model of managing patients' payments is no longer sufficient. Hospital executives must focus on a proactive approach to collecting payment upfront as well as improving patient education.
In a reversal of 30 years' past practice, Medicare may start to disclose what it pays individual physicians for its services to seniors.
In a reversal of 30 years' past practice, Medicare may start to disclose what it pays individual physicians for its services to seniors.
Hospitals have been acquiring physician practices and have been doing so for years, but a case resting in the hands of a federal judge in Boise is proving to be a "banner" case for these sorts of mergers and acquisitions.
Of the 2.2 million people who have signed up for coverage on federal and state health insurance exchanges, just 24 percent are young adults, the age group most prized for the healthy balance that they can bring to the nation's risk pool to hold down premium costs.
This week, CMS released a proposed rule that would make significant revisions to the Medicare Advantage and Part D prescription drug program regulations. The agency estimates that the rule changes would reduce Medicare spending by $1.3 billion between 2015 and 2019.
Halfway through the first enrollment period for health insurance exchanges, the majority of Americans potentially eligible for coverage have not yet visited one of the marketplaces.
New York's health insurance exchange is meeting enrollment projections and attracting a diverse mix of the state's residents, while trying hard to troubleshoot any website problems or consumer complaints.
Medical costs in commercial plans slowed between August 2012 and August 2013, according to the S&P Healthcare Claims Indices. Spending on inpatient, outpatient, and professional fees and pharmaceuticals all decelerated.