Healthcare Finance Staff
What's driving the highest per capita healthcare spending in the country? A half-decade's worth of government-funded research points to some contentious and perhaps uncomfortable trends.
Physicians groups want to preserve a key antitrust exemption for self-referrals under Medicare that the Obama Administration hopes to end for a number of costly services.
Health insurers can expect an increasing number of consumer education challenges around prescription drug management, as utilization controls are more prevalent in public exchange plans than in typical group insurance.
With open enrollment coming to a close, public insurance exchanges are starting to look like they won't be the money-loser many have been girding for, at least for WellPoint's health plans.
Amid problems ranging from the minor to the extreme, at least half a dozen state exchanges are offering enrollment extensions of sorts, but only one is pushing federal limits and trying to extend open enrollment.
Grab a photograph. Any photo. Then take it to a photocopier, and copy it.
A central hypothesis underlying the case for health reform's insurance expansion is being challenged by new evidence, as the quest to reduce emergency visits and spending continues. The research also highlights ongoing concerns about primary care access.
The largest national dual eligible demonstration project is taking a belated start in California, amid concerns from patient advocates. The concern surrounding the project indicates that new managed care plans have a long way to go, both in fixing problems in the system and getting buy-in from beneficiaries.
As Congress tries to reform Medicare, the program's independent advisor has its own suggestions, including a call to end to what has become a revenue buffer for many hospitals and an integral part of their physician acquisition strategies.
As Oregon transforms how it delivers care to 780,000 Medicaid patients, it hopes to generate better outcomes at lower costs. The problem is these goals conflict with hospital's traditional reliance on revenue from ER visits and inpatient stays.