Reimbursement

Medical identity theft is on the rise and hasn't shown signs of slowing down anytime soon, according to a new report released Thursday.

With health insurance exchanges opening Oct. 1, it will be essential that health plans pursue and keep up a high level of consumer awareness.

Two-thirds of U.S. hospitals will receive payment reductions tied to Medicare readmission penalties to see that improving the level of care will be the foundation for building operational sustainability in the future.

Because models for accountable care organizations are so new, it's difficult to predict if they will develop along the lines evident today, or morph into something else.

Polls show that few people understand health insurance or the Affordable Care Act. That's especially so for those who have the most to gain from Obamacare: people who are uninsured and haven't had health insurance for a while. It doesn't help that so much of the political debate and news coverage is about the battle over Obamacare rather than education about how it works.

Cancer care delivery is a system in crisis, with escalating costs, an increasingly aging population and complex treatments for a difficult disease stretching healthcare resources, according to a new Institute of Medicine report.

Changes to care delivery and payment models need to happen in order to improve a cancer care delivery system that is in crisis, found a new Institute of Medicine report.

With profligate use of CT and MRI scans widely blamed for increased healthcare spending, a new report shows that pairing automated prior authorization with evidence-based guidelines can ensure such tests are only used when necessary, improving patient safety while reducing medical costs by perhaps 40 percent.

Three healthcare executives shared the success factors that can propel shared savings and accountable care organizations and the pitfalls that can sink them, even as these value-based models are still in their infancy.

One of the first Affordable Care Act policies to take effect, the insurance medical loss ratio, has taken a bite out of profits in individual market businesses, but with less dramatic impacts to group health plans.