Reimbursement

Strategic growth through consolidation, optimizing care by finding ways to become more efficient providers make experts' list of healthcare issues to watch in 2015.

If 2014 was a year of managing member populations who need a blockbuster treatment for hepatitis C, 2015 is turning out to be one of deals for everyone to access that drug.

Is the nascent multi-state plan program a threat to health insurance competition, or possibly a surreptitious route to a public option? The Blues and co-ops will be how the market finds out.

Whether shopping for an airline ticket or a pair of shoes, consumers are making more purchases online. In the past, e-commerce for health insurance was confined to the individual market; private insurance exchanges, however, are bringing Internet shopping experiences to the broader health insurance industry.

After a massive data breach at the Garden State's largest health insurer, carriers and others now have to comply with data protection standards that exceed HIPAA. 

Insurers in one of the country's largest markets will now have to pay for telehealth, adding to the critical mass of reimbursement mandates and voluntary decisions for the service.

The nation's third largest insurer is joining the ranks of the most progressive companies and promising its wage-based employees a livable income, while also investing in less-than-traditional benefits.

Advocates of a radical reform solution are pointing to new evidence of the burdens of private sector administrative bureaucracy.

Provider and patient advocates are worried about a Supreme Court case that could restrict the ability to sue over low Medicaid reimbursement rates.

Conversations around end-of-life medical care can be challenging. Consider someone I'll call Mrs. Jones, an elderly patient with advanced heart disease.