Reimbursement

Medicaid expansion is making a difference as to whether hospitals are investing in clinics, new equipment and hiring new staff, or looking at the status quo and layoffs, according to a recent report by Georgetown University Health Policy Institute.

Aetna and Gateway Health are forming an accountable care organization and releasing a new individual insurance plan to sell on Healthcare.gov in time for the 2017 open enrollment period, both organizations said.

New failures are piling up among the member-run health insurance co-ops carrying out one of the Affordable Care Act's most idealistic goals, leaving just seven remaining when the health law's fourth enrollment season starts in the fall.

Another Affordable Care Act co-op has gone under due to the federal risk adjustment mandate and four more are expected to disappear by the fall, leaving the number of working co-ops at the start of the new enrollment season at seven.

With Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt announcing to the Senate Finance Committee Wednesday that the implementation of MACRA may be delayed, physician groups are weighing in, generally agreeing that a delay would benefit smaller practices in particular.

Red Oak claims self-insured or fully insured companies and their coverage plans administered by UnitedHealthcare have conspired to embezzle funds through a process called recoupment.

Americans in their 80s and 90s are not the ones amassing the largest medical bills to hold off death, according to a new analysis that challenges a widely held belief about the costs of end-of-life care.

The performance by Blue Man Group offers myriad best practices in care process redesign. Learn how standardization, localization, and scripted improvisation can be leveraged in the healthcare industry.

A new study by the Brookings Institution claims physicians would earn more in Medicare reimbursements under the Merit-Based Incentive Payment System mandated by MACRA legislation than with the alternative payment model.

Congress should revisit creating a public healthcare plan, President Barack Obama wrote in the Journal of the American Medical Association.