Reimbursement

Medicare pay cuts to physicians moved another step to being delayed and eventually eliminated as lawmakers again considered the sustainable growth rate formula for reimbursements.

Medicare Advantage has been using a risk adjustment payment formula since 2007, and now a similar approach is coming to insurance exchange markets.

Things are looking up for physicians fighting to get their payments from Medicare stable.

Among the businesses eyeing the growing market for employer self-funding is one of Colorado's health systems, the University of Colorado Health.

With HealthCare.gov better able to process applications, the focus now is making sure that consumer enrollment information sent to insurers is accurate so that coverage can be activated without a hitch Jan. 1 and advance payments to insurers based on tax credits can proceed.

Amid all the reimbursement and diversification strategies insurers are adopting in response to health reform, the Regence parent company is betting on its employees to nurture a portfolio of health technologies and services.

A few observations after 10 weeks of Obamacare implementation. The Obama administration released the first two months enrollment figures this week. With HealthCare.gov still struggling in November, the enrollment of 137,000 people in the 36 states was expected. The main event for the federal exchanges will play out in December now that most people can navigate it.

To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small? Turns out, many are very small.

To keep premiums down on the new insurance marketplaces, payers have created smaller networks of hospitals. But just how small are they?

Centene is expanding its role servicing high need populations, buying a majority stake in a home care management company.