Reimbursement

For many Americans, the ACA open enrollment period offers them an opportunity to have health insurance for the first time. But for hospitals and healthcare organizations, ACA open enrollments create financial and operational challenges.

Is Medicare adequately meeting the needs of seniors, or are there ways that its core attributes could be improved?  Few efforts have tried to understand how the public would change Medicare's basic design.

The Obama Administration will be telling us the website, call centers, and carriers are very busy with people all excited about the Affordable Care Act. They just won't be defining excitement.

Though slower than the worst spikes of the last decade, American companies and their workers continue to see healthcare costs increases, putting pressure on insurers to respond with new exchanges and plan designs.

More insurers are finding benefits in marketing new health plans with regional providers, as a way to leverage prominent brands, make networks more accessible and also create potential competitive threats.

In the Affordable Care Act's second enrollment period, insurers and exchange will again try to lure the young adult demographic, a challenge that will test risk adjustment policies and the best minds in marketing.

With new essential health benefit rules, some insurers are starting to take a more proactive approach to mental and behavioral health.

Taking stock of its diversification strategy, the nation's largest health insurer is creating a new enterprise oversight unit, moving around some key leaders and saying goodbye to others, all before a big enrollment push.

Does your organization have a planned response to virtual card claims payments by patients, and do you know your rights under the Affordable Care Act to a less expensive form of claims payment? It is important for providers to understand their rights under HIPAA and the ACA and make an educated decision.

Large national insurers have gotten lots of attention for investing in new technology and acquiring startups, but as it happens the Blues are making some of the biggest waves in the digital health space.