Healthcare Finance Staff
Though healthcare systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging.
Cancer patients insured by California's health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers.
The Centers for Medicare and Medicaid Services is developing a new model for how it pays dual-eligible health plans after an analysis showed it was underpaying these plans.
Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, and those cutbacks will affect customers in 37 states, according to the foundation.
Healthcare spending grew by 3.4 percent in 2014, a new report by the Health Care Cost Institute found, even though overall utilization declined.
The Massachusetts hospitals follow the exit of Dartmouth-Hitchcock Medical Center in New Hampshire last month.
The Big Data and Healthcare Analytics Forum kicks off on Thursday in Boston, with a host of expert speakers set to discuss how healthcare is using clinical and business intelligence to drive quality improvements, efficiency gains and cost savings.
In the first part of this series, we looked at a transformative year in healthcare and presented the ongoing shift from the Risk Adjustment Processing System to the Encounter Data Processing System.
Here we present submission deadlines and what success does, and doesn't mean, so plans are not surprised when a high acceptance rate results in unexpected file rejections or a lower than estimated risk transfer or reinsurance payment.
In our last column, we took a look at how U.S. health plans operate in a world of rising expectations based on: value-based reimbursement; consumerization; healthcare cost management; and regulatory compliance.
In this second part of the series, we'll give the best strategic plan of attack for each of these four trends.
The University of Pennsylvania Health System this week said it plans to partner with VPS Healthcare in the United Arab Emirates.