Reimbursement
It's almost game day for the second season of ACA insurance exchanges, and insurers need to get ready to handle all sorts of consumer inquiries and administrative tasks.
The competitiveness of America's state and regional health insurance markets is once again under question as patients and providers demand greater value propositions from payers.
The Centers for Medicare and Medicaid Services recently released more detailed ACO-level data for participants for the first two years of the Pioneer ACO Model. Despite the decline in participation and mixed results so far, upcoming regulatory may help.
A new molecular diagnostic approved by Medicare and Medicaid is among the first non-invasive alternatives to colonoscopies, a potential boon for patients and payers but also a new piece of the personalization puzzle to manage.
Cost-sharing in traditional Medicare is on the rise, and benefit designs in Medicare drug plans are changing.
The 2015 Medicare Part A deductible -- for inpatient hospital, skilled nursing facility and home healthcare services -- will increase by $44 in calendar year 2015 to $1,260, while the monthly Part A premium will decline by $19. Medicare Part B monthly premiums and deductibles will remain unchanged.
The Office of Inspector General at the U.S. Department of Health and Human Services continues to fault the Centers for Medicare & Medicaid Services for failing to issue final regulations to enforce the location requirements for rural health clinics.
As more providers adpot robotic surgery technology, more information on comparative effectiveness is raising questions about costs and benefits.
The new hepatitis C treatment Sovaldi has driven debate over drug costs for close to a year, but it's also been a case study in access and coverage in public payer programs.
Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.