Healthcare Finance Staff

When CDC director Tom Frieden, MD, stated that neuraminidase inhibitors (NIs), such as Tamiflu, should be given to all elderly people with upper respiratory infection symptoms even before they have flu, I was appalled. Having read the Cochrane Review report on NIs, it seemed clear to me that at best Tamiflu was ineffective, and at worst it could cause more harm than good.

The industry has changed. What were strengths are now limitations, and new critical success factors have emerged. The status quo may be the path to extinction.

In January, the Department of Health and Human Services set a goal for 50 percent of all Medicare provider payments to be the result of value-based compensation models by 2018.

South Carolina might be an unlikely place from which to run a small healthcare empire, but the state's oldest health insurance company is doing just that.

Corporate wellness skeptics are out early this year, arguing that the data is squarely on their side and that simpler, laissez faire approaches could be more effective.

Once again, insurance practices on cost-sharing and reimbursement for out-of-network providers and PPOs are ending up in dispute, with backlash from providers and customers.

Many health plans are looking for ways to maximize their performance in the new year. Payment integrity can help plans and other healthcare organizations operate more efficiently. But where to begin?  

Workers at Seattle's largest employer are signing up in droves for new ACO health plans led by regional health systems, who see the model as ripe for growth.

The Consult bought Scroggins Information Services for an undisclosed price.

The U.S. Department of Defense can look like a benefits company "that occasionally kills a terrorist." The agency has to overhaul its healthcare contracting, especially TRICARE, according to advocates.