Healthcare Finance Staff

The Centers for Medicare and Medicaid Services has named the first three participants in a program aimed at helping consumers get performance data of  physicians and hospitals in their local market. 

Covered California, the state-based health insurance exchange, plans to be financially self-sufficient by 2017 -- a goal all the more pressing in a state with some $617 billion in government debt.

As many as 31 million Americans now receive healthcare through an accountable care organization (ACO) according to a recent report "The ACO Suprise" from industry consulting company Oliver Wyman.

Insurance coverage for tobacco cessation varies widely and is often explained in convoluted and occasionally contradictory contract language, a study of 39 health plans has found.

Florida to make higher Medicaid payments; coalition urges Texas legislature to fully fund Medicaid program; and Conn. officials surprised by Medicaid enrollee growth in this week's Medicaid Digest.

Michigan lawmakers are transitioning Blue Cross Blue Shield of Michigan into a member-owned nonprofit, as the organization's historic mission as a tax-exempt "insurer of last resort" becomes unnecessary under the Affordable Care Act.

Implementation of the ICD-10-CM/PCS code sets creates a large degree of financial uncertainty and risk for payers. How reimbursement parameters will shift for each individual payer is only a matter of conjecture until claims start to be processed with ICD-10 codes. However, the delay of final implementation until 2014 gives payers an opportunity to conduct more thorough testing to better understand the impact on their organizations.

Nearly a year after providing guidance that broadly defined essential health benefits (EHBs), the U.S. Department of Health and Human Services on Tuesday put some meat on the bones with a detailed set of proposed rules that will determine the required components that must be offered beginning in 2014 through all non-grandfathered health plans.

With the passage of a ballot initiative this month, Massachusetts became the latest state to allow the use of marijuana for medical purposes, joining 17 others and the District of Columbia.

In the late 1990s, New York City small businesses saw surging healthcare costs and many small business employees were going without insurance. As part of broader efforts to warm the city's business climate, in 1999 mayor Rudolph Giuliani awarded a $1 million grant to the New York Business Group on Health to create the not-for-profit insurance exchange HealthPass New York.