Susan Morse

PwC report says administration is more likely to rely on free market levers, such as price transparency for providers and open negotiations with pharmaceutical companies than the traditional regulatory process.

Spillover effect from Medicare Advantage and the looming value-based insurance design model are leading the way.

Measures are closely aligned to those of the Hospital Inpatient Quality Reporting Program by the Centers for Medicare and Medicaid Services.

Physicians in value-based relationships with Humana had 19 percent higher HEDIS scores.

Cigna originally entered five markets, grew to seven states and had planned to expand to 10.

Company's profit fell 6 percent to $617.8 million and it expected ACA enrollment to fall by 300,000 members.

In 2014, recovery auditors identified $2.39 billion in overpayments and $173.1 million in underpayments repaid to providers.

Medicare Advantage takes on capitated risk, so why don't these plans qualify as an advanced alternative payment model?

Federal and state officials had raised the concern that both health systems operate hospitals in the northern suburbs of Chicago.

Payment differences have provided an incentive for hospitals to acquire physician offices.