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By now, it is no surprise which states have said they won’t expand Medicaid as outlined under the Affordable Care Act. And while there are still a handful of states on the fence, it’s a given that states like Texas, Louisiana, Mississippi and Georgia, among others, were not going to budge.

In January, the Affordable Care Act (ACA)’s individual mandate will enter the next phase of its roll out. Millions of uninsured Americans will face penalties if they do not enroll in a health plan. Uninsured problem solved, right?

Hospitals in states that don’t expand their Medicaid program as outlined under the Affordable Care Act are facing significant revenue reductions due to regulations that will reduce some Medicare and Medicaid payments in 2014, measures that were written into the law to help pay for the expansion of the insurance program for the poor.

In the early days of the latest incarnation of the patient-centered medical home, William Warning II, MD, the program director of a family medicine residency program, recognized an opportunity, and he wasn’t going to sit back and let it pass him – or his program – by.

On April 1, Highmark Inc. unveiled a group health plan aimed at larger employers and self-insured businesses that provides incentives for members to use providers that exhibit higher quality outcomes, fewer complications and reduced readmissions.

The American Medical Association has challenged a Georgia court’s blocking of a prompt payment law and in the process has raised questions about some of the pillars of federal preemption under the Employee Retirement Income Security Act (ERISA) as it relates to third-party administrators and self-funded insurance plans.

With a growing focus on continuity of care across settings, the Hospital Corporation of America North Texas Division (HCA) and First Choice Emergency Room, a freestanding emergency room system, have formed a partnership to increase access in Dallas-Ft. Worth region.

Since ICD-10 implementation affects almost every department in a medical practice or hospital, it's fair to say that it's more than a medical coding problem. There are plenty of challenges to tackle across the organization.

President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other healthcare providers that serve them.

While the massive, monolithic hospital isn’t a relic of the past, real estate investors don’t see it as the wave of the future, either. Not when emerging payment models favor outpatient over inpatient care, they say.