Reimbursement
Executive instructed office staff to rely on false anesthesia records when preparing claims for reimbursement sent to Medicare, Medicaid and the insurance companies.
Chief financial officers must determine the best value-based care model for their healthcare organization, experts say.
With new data from the Medicare Pioneer ACOs, accountable care advocates can be cautiously optimistic, although the pessimistic can also find things to latch onto as well.
As it happens with insurance, the emergency department utilization issue is pretty simple.
Cigna is seeing benefits from its variety of accountable care in obstetrics and gynecology, and is on track to expand the model.
Payers need to be focused on the development networks that are not just narrow, but offer both consumer choice and a shared value reimbursement.
Amid record enrollment, some Medicare Advantage insurers are finding their payment-linked risk scoring practices to be the subject of scrutiny and lawsuits.
Report claims that between 2015 and 2024, uninsured people in states not expanding Medicaid would rack up to $266 billion in uncompensated care.
Taking a cue from workplace wellness programs, more than a dozen states are offering Medicaid beneficiaries incentive to make healthier decisions. The stakes are huge.
The country's largest insurer is expanding coverage for virtual visits, a clear sign of legitimacy for a growing part of consumer-driven medicine.