Anthony Brino

With millions of Americans on new health insurance exchange plans now responsible for high deductibles, hospitals, drug makers, insurers and regulators are entering a new frontier of payment disputes.

A new interpretation of a 40-year-old law could offer healthcare providers more options for appealing payer recoupments or preventing them altogether.

If global spending becomes the norm in Medicaid, health systems, medical practices, home health and community organizations will face an even greater impetus to collaborate. In the Empire State, some are already starting the journey.

Almost a third of all hospitalizations now treat diabetic patients, and cost more than average. Diabetic admissions may be a problem that regulators, ACOs and providers need to solve for the long-term.

Fifty years after the U.S. Surgeon General's report on smoking, it's still not uncommon to see workers puffing cigarettes on the grounds of hospitals. To address this incongruence, some health systems have started taking a bold strategy -- barring smokers from employment, even those who don't work in clinical and patient support roles.

Seeking to bring in new skills and perspectives to help improve the experience for customers, several large insurers have recently hired executives from outside the industry.

In a region brimming with high-ranked hospitals but still suffering from poor care coordination, four health systems are initiating a new joint venture to find efficiencies and lure payer partners.

The proposal for next year's Medicare inpatient payments to hospitals continues the pressure on them, and doubles down on a controversial policy.

Many not-for-profit hospitals are still struggling to align revenue with capital deployment and expenses, a challenge that may grow as patients come in covered by exchange plans and Medicaid.

Hospitals may have less control over readmissions than clinicians, administrators or federal regulators would like to believe, new research suggests, meaning that the readmissions penalties imposed by the Centers for Medicare & Medicaid Services may be inappropriate.