Reimbursement
A new Republican majority focused on curbing regulation may give the healthcare industry the opposite of what most are looking for: uncertainty. Or they could turn to a fairly simple option to help the stakeholders long resistant to ICD-10.
The California-based nonprofit health system and HMO Kaiser Permanente is hustling and bustling this year.
DaVita HealthCare Partners, a provider of kidney dialysis services, is making a move into primary care, and has announced a joint venture with a hospital company in Colorado and Kansas. Some say the firm might be trying to create a model for Medicare to follow.
Public exchange shoppers will have more choices this open enrollment period, and in some places, they're being courted with affordability, as insurers try to draw both first-time buyers and membership from rivals.
The Medicare Payment Advisory Commission discussed last week the option of creating specific Diagnosis-Related Groups for one-day hospital stays, in an effort to reduce payment differences between short inpatient and similar outpatient hospital stays.
Defying expectations, the court announced last week it has agreed to hear a case that challenges the heart of the Affordable Care Act: subsidies to help people pay their insurance premiums.
Pre-reform underwriting approaches for speciality medications like HIV/AIDS drugs are not going to fly in the new health insurance market, as regulators and patient advocates intervene to challenge a range of practices.
Care coordination networks are a mainstay of the Affordable Care Act's cost reduction goals. Accountable care organizations are the most widely recognized of these networks, yet by no means is design of these business arrangements simple or straightforward.
What was once thought to be a Hail Mary attempt by Affordable Care Act opponents is now starting to look like a clear pass with a chance of being caught.
As we approach the second open enrollment for insurance exchanges, one thing is clear: purchasing individual health insurance will continue to be a complicated experience that involves multiple touch points and channels with payers and federal or state marketplaces.