Reimbursement

Depending on how much the program is reformed, it could mean the difference of hundreds of millions of dollars for the thousands of hospitals who get a drug discount.

The decline of CoOportunity Health of Iowa and Nebraska has Obamacare critics and executives at large insurers skeptical that co-ops can ever compete.

Aetna has found itself in the odd position of being fined for covering something some members wanted, while not being fully up to speed covering another condition.

The Advisory Board revenue cycle head Ed Hock says punting on ICD-10 until the new code set is ready robs healthcare providers of the benefits of the Oct. 1 changeover.

With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment.

The trajectory of cancer care is so costly and problematic that insurers are flocking in droves to the federal government's multi-payer alignment experiment.

Health insurer increases the minimum hourly wage for its U.S. employees to $16 per hour, and next year will expand health coverage.

"Instead of imposing this unfunded mandate, Congress should delink the disease classification system from reimbursement policy, and make the adoption of the new ICD-10 code system voluntary until a less burdensome billing process is in place," The Heritage Foundation wrote in a May 18 report.

With little more than a year of claims experience on the new individual market, some insurers are looking for premium increases of more 30 percent, including the Blues. Though affordability is still relative.

Seventy-three health systems and providers sold their own health plans on the ACA exchanges this year.