News

Cooperative health plans attracted more than 400,000 Americans during the first open enrollment period and, although their long-term viability is still not guaranteed, some are bullishly plotting to grab market share from incumbents next year.

Lack of preparation, even with the implementation delay, spells revenue cycle disruption.

Not-for-profit hospitals are facing huge revenue challenges amid payment reform and shifting payer mixes, leaving relationships with commercial insurers in a flux.

Our weekly look at career moves in the healthcare finance sector. This issue highlights promotions, hires and fires for the week ending April 25, 2014.

Many not-for-profit hospitals are still struggling to align revenue with capital deployment and expenses, a challenge that may grow as patients come in covered by exchange plans and Medicaid.

Physicians shouldn't feel threatened by the continued popularity of retail clinics with consumers, but neither should they ignore them.

So far, 2014 is not looking too shabby for some large insurers. Aetna, the Hartford-based giant, raised its outlook following a record quarter, but that doesn't mean there aren't headwinds.

A small uproar over provider networks in public insurance exchanges in Washington state has led to a proposed, controversial fix that, if adopted, has implications for other states, providers and insurers facing similar situations.

As a result of the push towards accountable care, increased patient census no longer translates to higher revenue for hospitals. Unless costs are managed internally, higher patient volume may instead lead to narrower margins, if not outright red ink.

The brains behind implementing much of the Affordable Care Act's new Medicare policies, Jonathan Blum, principal deputy administrator at the Centers for Medicare & Medicaid Services, will be stepping down from his position on May 16.