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Smaller practices that may not have the capital to invest in systems and staff to manage the coding change may seek out mergers, joint ventures or other partnerships.

Blue Shield of California is in the position of trying to keep its state tax exemption, while also defending its public image and defining its future mission to customers.

Leaders like Banner Health, Montefiore explain what it took to succeed in the first ACO model, and look towards new programs that give them shared risk incentives for care quality.

Expenses are climbing by 8 percent this year over last, from $416 billion in 2014 to $608 billion in 2015, according to a new report from Kalorama Information.

How much overhead in private and government insurance will it take to have universal coverage under the ACA? Quite a bit in one current view of the data.

Trend has driven up stock prices of the largest publicly traded travel-nurses companies.

Nearly one American in three with private health insurance got a surprise medical bill in the past two years.

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped.

After more than a decade of legal turmoil, physicians in four states have won a concession from the nation's largest insurer to make getting paid less of a hassle, if not to get paid more.

Among the major changes proposed for Medicaid plans are new provider adequacy standards, new mandates for capitated rate setting, beneficiary protections in long-term care, forthcoming quality ratings, and an 85 percent medical cost administrative ratio.