Reimbursement
Oscar says it uses technology to lower cost: More than 60 percent of member interactions with health systems are virtual.
UnitedHealthcare and Oxford Health Insurance contended the payments to New York were an unconstitutional taking of their property.
Site-neutral clinic payments, 340B drug program policy, adding procedures to covered list for ambulatory surgery centers all hit hospital margins.
From direct contracting between employers and providers to campaigns aimed at reducing the stigma around mental health issues, employers are doing it for themselves.
Insurer is investing in at-home and hospice organizations and is focusing on senior primary care through Walgreens partnership.
Some drug companies pay less than what they would otherwise owe by introducing a new drug formulation, HHS Secretary Alex Azar says.
Automating core administrative functions equates to unlocking $15 million in operating income for every 100 full-time employees, Accenture says.
Administrator Seema Verma says it's time for ACOs to take on downside risk, in a proposal that would save Medicare $2.2 billion over 10 years.
Amazon's tidal wave through healthcare industry continues as company is in talks to open primary care pilot clinic for select employees with plans to broaden access next year.
The 2018 benefit year will now determine risk adjustment payments to insurers, using the statewide average premium.