Healthcare Finance Staff

The raison d'etre and central function of health insurers has had a slow time coming into the 21st century. But with both providers and patients demanding a better experience, the impetus for progress could bring a critical mass.

I recently had to reschedule a routine exam with my hospital-based primary care doctor and so decided to use the supposed rescheduling functionality on the patient portal to carry out this task. 

Many years ago, there was a saying in American politics to describe an important bellwether state: "As Maine goes, so goes the nation." Today the state is still an important indicator, especially in healthcare. 

The price transparency movement may be picking up speed, but consumers lack the ability and resources to translate and comprehend the information.

Facing the fact that just 5 percent of the patient population was responsible for nearly half of its spending, one health organization has tried some fairly radical changes.

Medicare Advantage remains an attractive option for Medicare beneficiaries, and enrollment has increased substantially, by 66 percent in the past six years. Also increasing, it seems, is coding intensity for risk adjustments.

Just as American society's views and acceptance of transgender issues are evolving, insurers are facing choices, challenges and uncertainty in adapting coverage policies for LGBT.

Hospital systems buying up medical practices cite integration efforts and payment reform as a justification. Now, though, payers might rightly be concerned about where the trend can lead at local levels.

Amid a mulligan of sorts for a large state insurance exchange, an insurer with a new mission is using the old tactic of tapping brokers in a bid to vie in the big leagues.

The federal government is clamping down hard on some profit-focused patient referral and healthcare joint venture practices, although the company in question appears unfazed as it enters new forays, including some with insurers.