Reimbursement

Get ready, because data breaches are expected to rise in 2014, especially in the healthcare industry. New security threats and regulations that call for more transparency will be partly to blame.

HealthCare.gov has a new czar to replace fix-it guy Jeff Zients: former Microsoft executive Kurt DelBene.

Mired deep in early problems it didn't expect with the exchanges, Aetna turned to tools from its previous large enrollment experiences to get operations on track.

Tennessee's three incumbent Medicaid managed care organizations won the latest rebid contracts, although at least one of them may end up with fewer members and revenue.

Medicare pay cuts to physicians moved another step to being delayed and eventually eliminated as lawmakers again considered the sustainable growth rate formula for reimbursements.

Medicare Advantage has been using a risk adjustment payment formula since 2007, and now a similar approach is coming to insurance exchange markets.

Things are looking up for physicians fighting to get their payments from Medicare stable.

Among the businesses eyeing the growing market for employer self-funding is one of Colorado's health systems, the University of Colorado Health.

With HealthCare.gov better able to process applications, the focus now is making sure that consumer enrollment information sent to insurers is accurate so that coverage can be activated without a hitch Jan. 1 and advance payments to insurers based on tax credits can proceed.

Amid all the reimbursement and diversification strategies insurers are adopting in response to health reform, the Regence parent company is betting on its employees to nurture a portfolio of health technologies and services.