Reimbursement
Mothballing, busted budgets and a lack of credibility are swirling in the minds of ICD-10 managers, and it's enough to make some insurers question the logic of future investments.
Cigna is hoping to sustain positive first quarter results for the rest of the year, in part relying on expanding collaborative care initiatives, as new exchange members turn out to be surprisingly high utilizers.
The healthcare industry was shocked by another delay of ICD-10. After two previous delays, most healthcare stakeholders, especially health insurers, were operating at full steam to ensure that compliance date of 2014. Now the challenge is making sure all that work wasn't for naught.
New York's attorney general has fired what he hopes will be a warning shot at the industry of loan brokers and lenders targeting consumers who want to pay for elective procedures.
After the first open enrollment period, WellPoint executives are confident that public exchanges will be profitable and that they won't be bailing anybody out. Other areas, they're not so sure about, despite better than expected first quarter results.
With at least 15 percent of Americans now covered through an accountable care organization of some sort, integration seems almost inexorable. But not all is well in the land of Medicare ACOs, and in the private sector, the evolution may hit a few dead ends.
A recent analysis of the federal government's 340B drug discount program suggests that eligibility is too broad and that lawmakers need to tighten it, which may mean that hundreds of hospitals currently in the program would be booted out.
Growing more anxious about the impact of the expensive new hepatitis C drug Sovaldi and the routes states may take, Medicaid managed care organizations are looking for help.
Hospitals are educating their staff and reworking their processes to comply with Medicare's two-midnight rule, which will likely reduce hospital revenue by shifting patients from inpatient to outpatient status.
How do consumers want to talk to their health plans? By any means possible, please, and right now.