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In 2014, recovery auditors identified $2.39 billion in overpayments and $173.1 million in underpayments repaid to providers.

Medicare Advantage takes on capitated risk, so why don't these plans qualify as an advanced alternative payment model?

Federal and state officials had raised the concern that both health systems operate hospitals in the northern suburbs of Chicago.

FairChex found that, depending on the procedure, consumers looking at hospital ratings may choose a hospital for care not knowing they perform poorly in a certain procedure, effectively resulting in poor quality delivered at the highest cost.

The health system has been using telehealth to reduce emergency room wait times and power its telestroke peer-to-peer physician consult program.

Blue Shield of California, already under scrutiny from the Department of Managed Health Care, is on the hook for almost $25 million this year to enrollees and the employers that cover them and their dependents.

Payment differences have provided an incentive for hospitals to acquire physician offices.

The agency is also adding a three-item care transition dimension to the HCAHPS survey in 2018.

A reorganization of resources may not feel natural to your practice at first, but can yield big gains, revenue cycle director says at the MGMA conference.

The research underscores the need for doctors to talk to patients about ways to keep the drugs safely, especially if children are in the household.