News
With one open enrollment period closed and another beginning, HealthCare.gov and state exchanges have sold about 20 percent of the number of health plans that federal budget officials think is enough for a sustainable risk pool.
The California Department of Managed Health Care is trying to end the practice of emergency care "balance billing," just as thousands of new HMO members are being created.
Administrative errors resulting from adjusting to new policies has led to an increase in the improper payment rate for Medicare, the Department of Health and Human Services disclosed in its annual financial report.
Six months after merging to become the second-largest not-for-profit U.S. healthcare system, CHE Trinity Health is beginning to enjoy the strategic benefits promised by the union. The key factor driving the strategic rationale of the merger was the shared culture of both enterprises.
After several years on the decline, improper payment rates for Medicare and Medicaid increased in 2013, according to the government's estimates. How much of that represents fraud, though, still remains a mystery.
Our weekly look at career moves in the healthcare finance sector. This issue highlights promotions, hires and fires for the week ending December 27, 2013.
All the talk about moving healthcare reimbursement from volume to value sounds great, in theory. But how this shift takes place in practice is more complex than simply ending one form of payment and starting a new one.
In 2013, $2.6 billion of the $3.8 billion the DOJ recovered under the False Claims Act were related to healthcare fraud.
When 14 New Jersey hospitals took part in an initiative to improve overall efficiency in their operating rooms and emergency departments, they didn't expect to boost revenues and cut costs. But that's what happened.
As many as 1.5 million more Medicare beneficiaries now have access to coordinated care with the formation of 123 new accountable care organizations as of Jan. 1, the Health and Human Services Department has announced.