Reimbursement

Health reform is creating a new impetus for regional payers and providers to collaborate on long-standing problems. Medicare is proving to be a good place to start.

UnitedHealth Group's big data venture is plying new waters in deals with several powerful healthcare institutions, trying to create value with one of healthcare's largest databases.

US not-for-profit children's hospitals are likely to remain financially stable in the next year or two although changes on the horizon, including those related to healthcare reform, could affect the sector's traditional niche role.

For the many health organizations trying out or diving into accountable care, there are some important ideas from abroad to consider during the next stages of design and evaluation.

It's been pretty quiet lately on the Obamcare front, but that is about to change. To say this fall's open-enrollment has the potential to be problematic is an understatement.

Healthcare advocates for seniors are trying to stop a managed care expansion for the country's largest Medicare-Medicaid dual eligible population, in what could be a precedent for other states.

Americans living in rural areas will be a key target as insurers, states and nonprofit groups strategize how to enroll more people in exchange plans this fall.

The currents of health reform and consumerization are getting more treacherous for incumbent hospital businesses, but payers and retailers, especially, have waves to ride.

Aetna's ACO portfolio keeps growing, as the insurer tries to capitalize on Medicare Advantage rate pressure and step in where some competitors face upheaval.

Inpatient rehabilitation services are already a big target area for recovery audit contractors, and there will likely be more denials as audits ramp back up. Providers must remain consistent, proactive and vigilant to protect their revenue.