Reimbursement

Don't let errors that could have easily been avoided be the reason that CMS comes knocking on your door.

The company last year lost thousands of customers to the health law's online exchanges where consumers shop directly for plans and find out if they qualify for subsidies.

As Blue Shield of California fights to save its state tax exemption, momentum is growing around a movement to apply the same scrutiny to nonprofit hospital systems, and maybe collect the same taxes, as for-profit systems.

Admittedly, I won't be found listening to country music in Nashville, but there are many interesting forums and sessions worth exploring.

With the evolving Affordable Care Act reforms and widespread digitization of healthcare data, payers are likely to make significant investments in analytics and business intelligence.

A takeover of the company would likely be the largest health insurance acquisition since the $20 billion merger of Anthem and WellPoint in 2003.

When Wall Street's biggest M&A dealmaker is hired, it would seem that a takeover is in the making, or at least a possibility being mulled.

Inspired by the links between activity, meditation and wellbeing, the country's largest mutual insurer is sponsoring an app to help its members and the public take on stress.

Beyond letting providers assume more risk and savings from it, health insurers can put them one step closer to the aim of better care, improved outcomes and lower costs.

Imagine an altogether different kind of utilization management that both payers and providers appreciate, where approvals are made at the point of decision, not after the fact. Utilization management as we know it is flawed. But keeping some semblance of the old model is necessary and a smart way to move forward.