Reimbursement

Hospitals and managed care organizations in Rhode Island are set to take reimbursement cuts under the governor's proposed budget -- an untenable position, some say, as Medicaid expansion brings them more patients.

"Only 11% of consumers who bought new coverage under the law were previously uninsured," according to a survey of 4,563 consumers eligible for the health insurance exchanges done by McKinsey & Company and reported in Saturday's Wall Street Journal.

Small and medium sized medical groups are confronted with questions of survival on an ever-increasing basis.

Connecticut's health insurance exchange is the first to meet its enrollment projections, but officials might be hoping to attract younger Nutmeggers before the 2014 open enrollment period ends.

The first insurer to post last year's financial results, UnitedHealth Group saw revenues grow 11 percent but margins slip -- a sign of industry pressures ramping up in the new era of health reform.

Healthcare Finance News talked to Kevin Brennan, Geisinger's executive vice president and CFO, about the advantages the health system has seen by adopting the bundled payment model.

Empowered consumers, rapid innovation and increasing competition are among PwC's top health industry issues for 2014.

After recovering claims from a pharmacy provider, a group of 27 states are suing Novartis, alleging the company participated in a kickback scheme to boost Medicaid sales for a controversial blood drug.

Empowered consumers, rapid innovation and increasing competition are among PwC's top issues for providers and payers and other healthcare businesses for 2014, the company announced last week during a webinar.

Now that most consumer-facing parts of HealthCare.gov are working, the biggest problem is "making sure plans get paid," the lead manager of insurance exchanges and regulations at the Centers for Medicare & Medicaid Services told federal lawmakers.