Reimbursement
"Is this doctor in my insurance network?" is part of the litany of questions asked when considering whether to see a particular doctor. Unfortunately, the answer may not be a simple yes or no.
After decades of research showing at best mixed benefits, certificate of need programs are starting to look antiquated and deleterious in the age of consumer-driven healthcare.
Whether or not more co-ops falter, many insurers could learn from some of their goals and experiments, including in primary care.
Hospitals also saw a 55 percent reduction in uncompensated care visits in the first three quarters of 2014.
Miami man billed Medicare for home health services and physical therapies that were not medically necessary and bribed patient recruiters in exchange for patient referrals, prescriptions and plans of care.
Workers at Seattle's largest employer signing up in droves for health plans that pair workers with these networks.
After a weekend of Merlot, brie, oysters and chocolate (and maybe more snow), a sampling of the most prolific prose from an annual healthcare tradition: health policy valentines.
Medicare is looking for commercial insurance partners to join a multi-payer, physician-led effort aimed at "transforming" oncology and helping financing become more sustainable.
The predicted demise of health insurance brokers may have been premature. Industry veterans and entrepreneurs are carving out niches and expanding their roles in the new market.
Changes in open enrollments to come and evolving state and federal policies promise new uncertainties for insurers trying to soundly price their plans and retain membership.