Healthcare Finance Staff
The Affordable Care Act has given healthcare payers the opportunity to let Americans buy healthcare benefits in a whole new way: online. With a new open enrollment period right around the corner, the marketplace is changing how individuals think about and make healthcare insurance purchasing decisions.
While more payers and providers are trying to pursue value-based reimbursement models, some insurers are finding themselves fighting back against questionable fee-for-service schemes.
The federal government's employee advocate is trying to draw a line in the sand for wellness programs, and raising questions about the value and legality of some employers' incentive-based cost containment strategies.
The U.S. Department of Health & Human Services Office of Inspector General has issued two reports on implementation of the Affordable Care Act health insurance "marketplaces."
How much leeway do employers and insurers have in deciding whether they'll cover contraceptives without charge and in determining which methods make the cut? Not much, as it turns out, but that hasn't stopped some from trying.
Over a five-year period, five programs sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network to improve the quality of certain medical and surgical procedures performed in Michigan hospitals, have produced $597 million in healthcare cost savings, and have lowered complication and mortality rates for thousands of patients.
What's in a name? When it comes to health plans sold on the individual market, these days it's often less than people think. The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you're buying by name alone -- assuming you're one of the few people who know what an EPO is in the first place.
The idea of a new "copper" tier of health plans is being pitched for the most healthy and cost-conscious consumers.
One of the most acrimonious disputes of the insurance exchange debut is coming to a close, in a testament to the market influence some providers now have.
Oregon is mandating Medicaid coverage for gender dysphoria treatment, bringing it in parity with the state's progressive commercial market and also putting pressure on other states and insurers.