Healthcare Finance Staff

The practice of taxing Medicaid managed care organizations to raise revenue for state-share payments has left some auditors scratching their heads, raising questions that could shake up financing models.

Among all of the public money that federal healthcare watchdogs are trying to follow is a lot that will continue to be devoted to marketplaces and tax credits.

Around the country, narrow provider networks are sparking consumer backlashes, prompting regulatory intervention and also raising questions about the value of current insurance designs.

Health insurers' most profitable book of business may be on the way out. If the projections of Fortune 500 companies are to be believed, the next half-decade will be sink-or-swim to the other end of evolving exchange markets.

The annual PayerView Report, from health IT company athenahealth, reveals the healthcare payer that has the best relationship with providers and the one that has the most problems.

Medicare Advantage insurers may soon find themselves facing new public scrutiny over potential spending and overpayment discrepancies.

In the search for meaningful patient care improvements and sustainable financing, some independent physician groups are charting unique approaches that may offer models for payers and providers in the age of cost-containment and risk-sharing.

States, insurers and self-funded employers are facing mounting pressure to expand autism coverage, but some may be too slow for advocates.

The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled.

Amid the transition to the Affordable Care Act, startup companies looking to augment, service or replace health insurance have been getting record investments.