Reimbursement
Poverty continues to have an effect on repeated hospitalizations -- a situation that threatens to cost health systems in higher Medicare readmissions penalties if post-discharge plans are not established.
Consumers shopping on the health insurance marketplaces will find many plans with out-of-pocket spending limits that are lower than the maximums allowed under the health law, according to an analysis by Avalere Health.
Many payers face profitability declines while also taking in a huge influx of newly insured members whose risk profiles are unknown. Payers continue to see billions of dollars in error rates on claims each year, and fraud and other abuse further erode the bottom line.
The latest salvo in the pharmaceutical price wars is being launched from an unlikely outpost, but one that represents the struggle to pay for the year's most successful drug.
If hospitals are required to record unique device identifiers (UDIs) in electronic health records, there will be a need for supply chain involvement. But what that involvement should look like--and when--is still unknown.
A $1.1 trillion Congressional spending deal approved Wednesday night includes millions for healthcare related services, but holds spending on programs tied to the Affordable Care Act.
A young adult generation with college debt, limited assets and an uncertain job market who rarely need to use the healthcare system should be prime customers for low-premium, high-deductible health plans. Not so, some data suggests.
A large handful of cooperative insurers created through the Affordable Care Act have lowered 2015 premiums in a bid to boost membership in their second year of operation, upsetting traditional insurers.
A startup health insurer trying to capitalize on digital services and simplicity is now offering members wearable devices and incentives for activity, another step in its bid to disrupt health insurance.
The era of consumer-driven healthcare puts the consumer in the driver's seat. However, the added responsibility can be daunting when you aren't sure where to go. They need guardrails.