Healthcare Finance Staff

U.S. hospitals were already under pressure as a result of healthcare reform legislation and reduced reimbursements. Now declining patient volume is pushing hospitals toward the boiling point.

One state is finding new approaches to managing Medicaid frequent fliers.

Federal health officials are increasingly scrutinizing Medicare Advantage risk adjustment, suggesting policy changes and even clawbacks to come.

Pretty soon, 24/7 digital access to a physician or nurse practitioner could be a standard health plan benefit.

Walmart is taking another, bigger step into American healthcare with new primary care services. Is a health plan next?

The diabetes crisis and pay-for-value evolution are coming to a head, helping change provider reimbursement in Medicaid.

There's been a lot of talk about compliance lately. Federal and state regulations. HIPAA regulations. But, if you're in charge of healthcare security, compliance is far from sufficient, according to one large insurer.

Access to prices and just a bit of nudging seems to not only help members find the best deals on elective health services like imaging but also spur some competition among providers.

At a time when states are both reforming Medicaid and expanding managed care, insurers have a lot of opportunities to grow business and increase value, but also many challenges.

Startups and investors from Silicon Valley to the Charles River are chasing after the next paradigm-shifting blockbuster innovation. But are any of new companies developing technology that will truly help transform healthcare?