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Medicare & Medicaid

By Susan Morse | 05:10 pm | April 04, 2018
MA star ratings improvements can help plans expand their share of an increasingly saturated market.
By Jeff Lagasse | 12:40 pm | April 04, 2018
Paying hospitals a fixed global budget reduced their prices but individual physicians continued to be paid on a fee-for-service basis.
By Beth Jones Sanborn | 04:23 pm | April 03, 2018
"The survey strongly suggests that the majority of physicians would like to move away from the Medicaid status quo," Merritt Hawkins EVP says.
By Jeff Lagasse | 04:01 pm | April 03, 2018
While conventional wisdom holds that it should be more challenging for doctors to bill private insurers, the results show that billing Medicaid is a bigger challenge.
By Susan Morse | 03:44 pm | April 03, 2018
The integrated provider-payer network is expected to grow as Lumeris builds a network of physicians and hospitals outside of the BayCare system.
By Jeff Lagasse | 01:05 pm | April 03, 2018
While the MSSP overall was a net cost to CMS in 2016, there is evidence that individual ACO performance may improve with experience.
By Susan Morse | 07:57 pm | April 02, 2018
CMS is also increasing the percent of encounter data in risk scores, a move opposed by stakeholders.
By Susan Morse | 11:23 am | April 02, 2018
The alliance is one of the first, if not the first, national blockchain alliances for healthcare, says Optum engineer.
By Susan Morse | 03:59 pm | March 30, 2018
AHA and three of its member hospitals had sued HHS due to the long delay in processing claims appeals.
By Jeff Lagasse | 11:10 am | March 30, 2018
Diagnosing patients during the mild cognitive impairment stage could both save money and make the condition more manageable in the long run.