Reimbursement

Official projections of long-term Medicare spending were lowered sharply in response to the ACA. It seemed like the ACA had made a major dent in addressing our long-term fiscal challenges. But had it?

The state that put itself on the vanguard of health reform only to struggle under the weight of its own ambition is now has an ultimatum for fixing its public insurance exchange.

The retail health chain that could have helped reprise Humana's historic roots turned out to be a good lesson in the evolving convenient healthcare space, plus it brought a tidy profit.

Amid a ballooning deficit, policymakers in Delaware are scrapping a proposal to introduce more cost sharing for state employees, a decision that may come back to bite when the Cadillac Tax arrives.

The bill proposes to increase payment accuracy, encourage physicians to adopt proven practices, supply doctors with data to improve care, and, for patients, to make Medicare more transparent by them more access to information.

Here are ten steps payers and providers can take today to speed their ability to align with value-based models. With a new vallue-based imperative from CMS, there’s simply no time left to delay.

This isn't just theoretical. I was approached by a consultant representing large U.S. employers who were exploring pharmacy tourism that would send patients abroad for their drugs.

Another cooperative insurer is boasting about low premiums attracting droves of new exchange members, raising questions about long-term viability in the wake of CoOportunity's liquidation.

The new proposal will repeal the current Sustainable Growth Rate and institute a 0.5 percent payment update each year for five years.

Highmark is expanding a low-cost approach to colon cancer screening that could help increase early detection while also avoiding the discomfort of invasive scoping and high treatment costs.