Reimbursement

While majorities of healthcare providers see value-based payment models becoming the reimbursement status quo in coming years, fewer than one-in-three say the reward is worth the risk.

Consumer concerns about new health plan networks continue, with two new members suing over a preferred provider network they say was deceitfully marketed.

As a payer and provider and the country's largest managed care organization with a lot of digital and online patient data, Kaiser Permanente has tried to address privacy and security head-on, and may pave a way for others.

As part of a contract extension with Tenet Healthcare, Cigna has established a first of its kind quality-based reimbursement agreement.

The corporate saga of a Medicaid managed care fraud case is coming to a close as three former executives head to federal prison, offering a cautionary tale for public benefits contracting.

Just in time for plan application and premium rating season, federal regulators have finalized market policies for the ACA's second open enrollment period, while continuing the tradition of leaving a few important issues to-be-determined.

In this video from The Texas Tribune, Becca Aaronson reports on a state investigation into misspent Medicaid dollars after Texas spent more on Medicaid orthodontic services from 2008 to 2010 than the other nine most populous states in the nation.

If global spending becomes the norm in Medicaid, health systems, medical practices, home health and community organizations will face an even greater impetus to collaborate. In the Empire State, some are already starting the journey.

Last week, the Centers for Medicare & Medicaid Services published a final rule that reforms federal health policy regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on healthcare providers and suppliers. Here are some highlights.

Value-based purchasing introduces the potential for unintended consequences, and needs to be monitored to avoid disparities between hospitals. But it's too early to claim that VBP puts disproportionate share hospitals at a disadvantage.