Healthcare Finance Staff
As the country gets ready for the roll out of the major components of the Affordable Care Act, stakeholders can look to Massachusetts, where healthcare reform was enacted seven years ago. The second installment of PwC Health Research Institute's The Massachusetts Experience provides analysis on the effects of rapid insurance coverage expansion on health payers and providers in the state.
The Nebraska state auditor has found what he calls "gross mismanagement" in the state's Medicaid Health Insurance Premium Payment Program (HIPP), with the state Department of Health and Human Services "flagrantly disregard(ing) its own regulations."
The Medicare trust fund would be quite a few billion dollars smaller without the contributions of immigrants -- especially those in the U.S. illegally, the source of fractious debate in current immigration reform legislation.
The U.S. Departments of Health and Human Services, Labor and the Treasury released on Wednesday final rules describing the standards for employment-based wellness programs and rewards associated with them as part of the Affordable Care Act.
Geographic Medicare costs disparities have more to do with health differences across communities than with inefficient care delivery, according to a new study from the Center for Studying Health System Change.
According to the results of a study published Tuesday in Annals of Emergency Medicine, disabled Medicare patients under age 65 who are unable to take their prescription medications due to cost concerns are more likely to visit the emergency department at least once during the course of a year.
The Vermont Department of Financial Regulation has rejected the licensing application of the Vermont Health CO-OP, finding "an extremely high risk of insolvency" and effectively barring the CO-OP from selling on the state insurance exchange this year.
Covered California, soon to be the nation's largest state insurance exchange, is touting the relatively low premium rates tentatively secured for individual health plans -- but HIX officials are comparing those to existing small group market rates, which isn't entirely apt.
Claims overpayments are more than a nuisance; they are an epidemic. Between $68 and $226 billion is lost annually to Fraud, Waste and Abuse (FWA), according to the National Health Care Anti-Fraud Association (NHCAA). As much as 10 percent of healthcare spending is attributed to abuse alone, with the federal government losing more than $70 billion to improper Medicare and Medicaid payments in 2010.
In the first disclosure of individual health insurance premiums by the nation's largest state, California announced on Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act.