Healthcare Finance Staff

It's a situation that occurs all too often: Someone goes to the emergency room and doesn't learn until he gets a hefty bill that one of the doctors who treated him wasn't in his insurance network.

More Americans than expected opted out of the individual insurance mandate, including some who didn't even have to.

The latest deal by diagnostics company Theranos suggests that the old school and new school can collaborate, and that the Blues might have a little something up their sleeves.

Instead of retiring, Marilyn Tavenner, the former nurse, hospital executive and Medicare administrator, is going to represent the economic and political interests of American health insurers.

With millions of Americans joining the ranks of those with health insurance under the Affordable Care Act, payers need to become even more vigilant in controlling costs.

Medicare turns 50 years old this month and has recently given a nicely wrapped present to advocates for more healthcare dollar value: a better way to pay for hip and knee replacements in the form of bundled payments.

Population health brought evidence-based medicine to the family doctor's office, vastly improving the overall quality and consistency of care in this country, but in doing so, it forgot about the individuals who make up the population.

Few days went by last year when New Hampshire nephrologist Ana Stankovic didn't receive a payment from a drug company.

Maryland same-sex couples who wanted to take advantage of a state law that requires insurers to cover pricey in vitro fertilization treatments used to face insurmountable obstacles. Not anymore.

A Michigan hematologist will likely spend the rest of his life in prison after defrauding Medicare and private insurers, and violating the first tenet of medicine, "Do no harm."