Healthcare Finance Staff
Just like that, the massive code set conversion won't happen before Oct. 1, 2015 unless President Obama derails the legislation.
New York is poised to solve one of the most pernicious consumer healthcare billing problems, and regulators think it could be a model. But for insurers, the new process may or may not be the ideal solution, especially when paired with new network requirements.
A group of chiropractors went to war with the Blues and it seems they've won, successfully using a novel legal theory that now has lawyers setting their sights on other large insurers.
Kaiser Permanente is hiring an integrated care specialist but organizational outsider as its new chief medical officer, as the focus on innovation comes to the fore.
As the Affordable Care Act continues to disrupt the health insurance industry, health plans must broaden their definition of risk as they calculate rates and attempt to better understand their members' needs.
As the quality and cost transparency movements gain support within the healthcare industry, a more important question persists: what will actually work for consumers?
The "cost to do business" doesn't have to be so expensive for government-sponsored health plans. Most payers are overspending on their annual print and fulfillment budget for member communications by 10-15 percent.
The many moving parts in the government's ACA plan transition policies are creating a range of new complexities for premium pricing, member pools and the new risk-sharing programs.
Only five states states are making headway bringing more price transparency to healthcare markets, but they could be a model for others, especially those with all-payer claims databases.
The federal government is promising that anyone who wants to buy subsidized insurance will be able to as long as they try to enroll before March 31. But insurers should expect more surprises and lingering work from complex cases.