Reimbursement

Much has been written (and will continue to be written) about the spectacular failure of health insurance exchanges in Minnesota, Massachusetts, Oregon and Maryland -- all blue states that support the Affordable Care Act.

As a healthcare consumer, am I most interested in short-term complications and readmission rates or am I interested in getting cured of whatever I have? The recent hullabaloo over narrow networks and whether a more expensive hospital is worth it or not seems to miss the bigger point.

Colorado insurance regulators are launching a probe of state healthcare costs, after residents in three mountain counties brought attention to their dubious distinction in the new healthcare economy.

Florida Blue and the nation's second largest public healthcare system are launching a clinical integration program in South Florida with a bold bet on the evolving frontier of paying for value.

Liberty Mutual has won a reprieve from complying with Vermont's mandated health insurance claims reporting, a victory that may extend self-funded plan preemption to a range of state regulations.

Humana is starting the year posting a fourth-quarter loss, preparing for Medicare Advantage reductions and worrying a bit about commercial risk pools. But with revenue growing, the company is banking on an integrated insurance and care model.

Just 10 months out from the ICD-10 compliance date, fewer than 10 percent of physician practices say they've made significant progress in their readiness for implementation, according to the Medical Group Management Association.

In a settlement for alleged violations of an extended version of the "stay on your parents' plan" policy, New York's attorney general is hoping to "send a message to insurance companies."

Not content to just sell on other private exchanges or see clients flock to them, Cigna is launching its own online benefits marketplace for employers and their workers.

Once notorious for widespread and brazen Medicaid fraud schemes, New York is making history these days by recovering more ill-gotten Medicaid dollars than ever before.