Reimbursement

There is a common misconception in healthcare that nearly all value-based care models are one-of-a-kind. If this were true, the lessons learned from these approaches would not be replicable. In truth, while the starting point for value-based care models may be unique for many organizations, they are actually conceptually quite similar.

Consumer advocacy groups are taking on California's medical establishment, trying to expand the power of rate review in a ballot initiative that's already drawing a lot of political money.

There is a common misconception in healthcare that nearly all value-based care models are one-of-a-kind. In truth, while the starting point may be unique for many organizations, value-based models are actually conceptually quite similar.

Lawmakers took another step toward repealing the reviled sustainable growth rate formula that sets physician payment in the Medicare program, but they still haven't figured out how to pay for it.

Cigna's 2013 report ended a week full of news about slipping Medicare Advantage profits, but the company is still betting on U.S. seniors while also looking abroad.

Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.

Kaiser Permanente and the Veterans Health Administration, which are providers and health plans, are partnering to study and share best practices in connected health and virtual care.

Aetna reported higher fourth-quarter profits propelled by revenue from its Coventry Health Care acquisition and is looking to its Medicare and managed care business for growth in 2014.

If Massachusetts' beleaguered health insurance exchange is going to be saved, the governor thinks a Blue Cross executive and a UnitedHealth tech company are the ones who can do it.

Lawmakers took another step toward repealing the reviled sustainable growth rate formula that sets physician payment in the Medicare program, but they still haven't figured out how to pay for it.