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In states that don't expand Medicaid eligibility, thousands or even millions of low-income Americans may find themselves in a new healthcare donut hole: too rich for Medicaid and too poor for insurance tax credit subsidies.

Anticipated shortages in healthcare professions are causing savvy healthcare organizations to turn to labor forecasting and workforce planning strategies.

The Department of Health and Human Services has asked the University of Miami Hospital to pay back $3.7 million to Medicare for incorrectly billed inpatient claims uncovered in an audit but the hospital is disputing the government's calculations.

Almost 50 million Americans were uninsured as of 2011 and, what's more, a projected 71 million are expected to purchase insurance between now and 2018 via the new health insurance exchanges.

Never has Medicaid been in such a state of flux, with dozens of new policies evolving in the states in response to delivery and financing challenges, as millions more Americans join the program.

Physician group practices are hesitant to participate in the health insurance exchanges because they worry about payment collections and lower reimbursement rates, according to research from the Medical Group Management Association.

Investing in data warehousing may pay off for the healthcare industry, but the key to success lies in how to mine that data.

As healthcare expands globally, more health organizations are relying on a wider variety of professionals to help keep their organizations up to speed. Here are some top trending medical degrees.

Humana Inc. is testing the use of an enhanced medical alert system with its Medicare Advantage members to prevent serious long-term effects of medical emergencies and falls.

Amid what the Kaiser Family Foundation calls "some of the most significant changes to Medicaid since its enactment," California Medicaid policy is evolving at perhaps the quickest pace, trying to manage the $55 billion in annual spending.