Reimbursement
"Isn't that covered by ObamaCare?" Public understanding of the Affordable Care Act has not been great, with a fair amount of confusion about key provisions and benefits detected by surveys.
Hanging around actuaries as long as I have, one of the old sayings I picked up was: "Figures don't lie, but liars figure."
Insurers that trace their ancestry back to the first days of American health insurance are now facing potentially existential challenges.
Trying to wean themselves off fee-for-service reimbursement, some health systems may be taking a non-committal strategy, dipping their toes in the water before deciding if they want to learn to swim. Insurers should be looking for more than that, if they can offer the right expertise.
Last week the HHS Office of Inspector General and the Centers for Medicare & Medicaid Services published a joint notice continuing the effectiveness of fraud and abuse law waivers granted in 2011 in connection with the Medicare Shared Savings Program.
Like many other industries, from manufacturing to retail, healthcare is looking to use information technology to transform and automate financial payments. Providers, though, have a lot of old and new choices.
Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don't include hospital benefits. Now the administration is concerned too.
Passing a key corporate milestone, UnitedHealth Group is on track to have a banner year, while trying to reshape large swaths of American healthcare.
Rising interest rates and regulatory oversight will be the top challenges confronting the senior care industry over the next year, according to a new survey of housing and care providers. But industry leaders feel good about a stronger business performance outlook.
This week CMS launched an ACO Investment Model, which will provide up to $114 million in upfront investments, to up to 75 Medicare Shared Savings Program ACOs. The program aims to help ACOs succeed in the MSSP by providing upfront capital to cover startup and ongoing infrastructure costs.