Reimbursement

One Blue insurer will find out just how much employer appetite there is for health plans with limited but transparent networks branded as both accountable and affordable.

The land of the Green Mountains, dairy farms and maple syrup is no longer pursuing the progressive dream of a single payer healthcare system, although it may still be on the vanguard trying to regulate affordability and access.

Despite the marketing buzz carried by terms like "population health" and "integration," experts say this kind of regionalization works best with partnerships between providers and commercial payers.

There are two ways of thinking about, and therefore measuring, the rate of hospital readmissions, and they often lead to quite different results and quite different decisions on Medicare penalties.

One Medicare Advantage company offers a parable for what can go wrong in the business of managed healthcare.

A fractious and potentially costly family of provider-led class action lawsuits are moving through courts, pitting accusations of illegal clawbacks againsts the likes of Aetna and UnitedHealth Group.

More than 1 million people selected a health plan during the fourth week of the health law's open enrollment and nearly 2.5 million have done so since it began Nov. 15, federal officials said Tuesday.

More than $665 million will be distributed to states around the country to test new service and payment models, the U.S. Department of Health and Human Services said Tuesday.

Private physician practices may soon be a thing of the past, according to a new survey that shows them dwindling year over year as more doctors opt to become part of a hospital or health system.

Independent Bill Walker, who won election last month in a governor's race so tight the results weren't known a week after the voting was over, campaigned on the promise that he'd expand Medicaid as one of his first orders of business.