Reimbursement

After one of its worst years ever, one Blue Cross company is banking on an insider and native son to lead a comeback.

Business has a vital concern in the financing of healthcare. So why is there not an outcry to switch to a proven financing system that would serve their employees well?

In a region dominated by one insurer and teeming with health systems, accountable care models are gaining provider acceptance but still accumulating evidence.

Though the deadline for complying with significant reforms of the Affordable Care Act has come and gone, payer organizations across the country are still adapting to the newfound complexities of their evolving industry.

After quietly building a small insurance unit, one of the nation's largest health systems is launching a new health plan brand that could pose more competition for established insurers.

The healthcare tech boom continues, as one of the most-heralded consumer insurance comparison startups was acquired by an insurance services firm hungry for growth.

Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive's spines.

Uncompensated care was supposed to be a thing of the past, but it's persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option.

Group plans are increasingly expanding their consumer-directed health plans with health savings accounts, after toying with lower deductibles and reimbursement account wrapping.

If we don't fundamentally change the way we pay for healthcare, we won't change the economic principles that continue to drive the rapid growth in healthcare spending. Let's pay physicians and hospitals based on the health problems their patients have.