Reimbursement

Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.

Medicare's Hospital Insurance Trust Fund won't run out of money until 2030. That's four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act.

A Pennsylvania provider is suing a health insurance company for passing on its 2 percent reimbursement cut required by sequestration.

Insurers trying to ride the wave of private exchanges need to be careful not to get swept up or knocked overboard amid varying business models and high customer expectations.

Perhaps the biggest consumer problem Obamacare has is that the plans with high premiums even after the subsidy, big deductibles, and narrow networks are not attractive to working class and middle class families and individuals who don't qualify for the biggest tax credits.

Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.

When it comes to speeding up the revenue cycle, the hospital pharmacy has its own part to play.

With new incentives, hospitals are increasingly making the reduction of complications, infections and readmissions a priority, but there are still infrastructure gaps that can tangle payer-provider collaboration.

In recent years, there has been an incredible transformation in the healthcare industry, especially in the role of consumers. A decade ago, health plans worked with employers to manage almost all health benefit decisions, leaving consumers relatively unaware of the costs associated with their healthcare needs. Not so today.

While some state exchange executives exited their exchanges amid foundering technology and low public esteem, the director of one successful state HIX has landed in the growing private exchange unit of a large national insurer.