Reimbursement

An ambitious primary care company co-owned by Philadelphia's dominant insurer is growing, recruiting new provider partners and getting scale for more patients.

The nation's largest Blue Cross Blue Shield insurer has to find its way out of what may be the largest healthcare data breach ever, casting a dark cloud on the outlook for a prosperous, transformative year.

HHS has, for the first time in the history of the Medicare program, set a goal of pushing a significantly larger share of Medicare payments through alternative payment models such as accountable care organizations (ACOs) and bundled payments.

Government budget forecasters are predicting some potentially disruptive consequences from the Affordable Care Act's pending Cadillac Tax.

So what can Massachusetts do to address their risk adjustment woes? They are taking a step in the right direction by recognizing that data quality is at the core of any corrective action.

Organizations will see higher Medicare payments when you combine their quality bonus with any readmissions or hospital-acquired conditions penalties.

With the surging costs of specialty drugs, what was once unthinkable in American healthcare is starting to look like a viable idea that the President is pushing.

President would reduce the Medicare budget by $400 billion over the next 10 years.

A regional Blue Cross insurer in the southern Midwest is turning to a long-time marketing executive to guide it into the next generation of health insurance.

New Jersey's largest insurer is expanding its medical home program in an effort to boost primary care access and member satisfaction, as new competitive threats loom from non-traditional insurers.