Anthony Brino

With a new study showing both inpatient reductions and specialty care increases linked to high-risk medical home patients, health systems have more evidence to buy into the PCMH model as part of their clinical and financial improvement strategies.

Emergency rooms across the country need to prepare themselves for an increase in ER visits as more uninsured people gain insurance under healthcare reform.

Medicare's Trust Fund has a 12 years of solvency left and seniors are also being forced to pay more, making it a ripe time to reform today's haphazard payment system, argues Medicare's independent advisor.

Hospital pharmacies can be huge sources of spending and also good sources of meaningful data. Healthcare Finance News talked to a data-driving hospital pharmacy director to learn how evolving analytics tools can help reshape clinical and financial approaches for the better.

The financial impact of the two midnights rule remains an open question and so is whether recovery auditors will challenge fewer claims or just shift their focus.

A new federal regulatory proposal to ensure adequate insurance networks could help not-for-profit hospitals, Moody's said in a briefing released this week.

The number of people determined eligible for Medicaid since the launch of new insurance marketplaces is approaching 10 million, according to new data released from the Centers for Medicare & Medicaid Services.

As more Medicaid beneficiaries gain access to behavioral health treatment, peer support programs offer a lot of benefits, but cost savings may not be one of them.

Cigna reported solid revenue growth in 2013 but the insurer plans on being proactive in order to curtail rising costs.

Humana reported a fourth-quarter loss, but, remaining positive about 2014, reaffirmed its financial outlook for the upcoming year.