Reimbursement
While population health models are wonderful, they have happened too sporadically. The healthcare payment system is not supporting this work and the U.S. needs a value-based system that accurately rewards population health models and initiatives.
Changing eligibility standards could purge a million or more beneficiaries from Medicaid rolls in California. A lawsuit seeks to stop the state from canceling coverage for Medi-Cal recipients who haven't been properly notified.
One of the greatest concerns among patient advocates, regulators and insurers alike is that buying and using a health plan may be too complex a task for some consumers. One state exchange is hoping it found a scalable solution.
Americans consume a staggering amount of the opioid painkiller hydrocodone, about 99 percent of the world's supply. In October, after 10 years of debate the Drug Enforcement Agency (DEA) reclassified medications like Vicodin, and products that combine hydrocodone with other drugs, as Schedule II controlled substances.
Americans working to improve their eating and activity habits often fail, and not for lack of investment by employers, insurers and wellness vendors. Despite, or perhaps because of those challenges, Cigna is taking another crack at the problem.
The nation's highest rated health plan is going through some growing pains and trying to make it to 2015 intact.
Nationally, the new individual exchange market seems competitive going into its second year, with a variety of plans and reasonable premium increases. At the local level, though, consumers may experience some havoc.
The Affordable Care Act is injecting billions upon billions of dollars to provide Medicaid to previously uninsured people. More money should help healthcare providers' finances, not hurt them. So what's going on?
The Affordable Care Act's online insurance exchanges launched this weekend with far fewer problems and less fanfare than last year. Many people qualified for federal subsidies that kept their monthly premiums well under $100.
By most accounts, the federal marketplace that handles enrollment for 37 states is running well, but there are still uncertainties, notably millions of confused American consumers.