Actuaries are pressing HHS to allow health insurers to revise their rates for 2016 coverage if the U.S. Supreme Court invalidates the Affordable Care Act's premium subsidies in federal exchanges.
The popular stereotype of the role played by medical malpractice insurers in the nation's healthcare system is not positive. And it's true that hospitals and their insurers can be wary and contentious partners, tied together by financial necessity and the stark realities of a litigious society. But...
Healthcare spending grew faster than the rest of the economy last year despite the ongoing reduction in hospital use and an industrywide campaign to hold down costs. How can that be?
Payers' efforts to drive down hospital prices may be succeeding. Prices that private and public health insurers paid to acute-care hospitals declined in January, compared with the same month a year ago, the first time they have dropped since the federal government began collecting these data.
The CMS has proposed increasing health insurers' Medicare Advantage payment rates by 1.05% for 2016, a move that kicks off a 45-day dogfight in Washington before the rates are cemented.
The Department of Justice has asked health insurer Humana for more information about its Medicare Advantage risk-adjustment practices, based on a whistle-blower lawsuit from several years ago, Humana said last week in a regulatory filing.
Paula Ercolini is one of about 1.8 million seniors who are part of a Medicare Advantage advocacy group that is blitzing the airwaves and putting pressure on the Obama administration and Congress.
Mark Ganz, president and CEO of Cambia Health Solutions, a not-for-profit parent of 22 companies offering healthcare products and services, discusses how his companies are seeking to make healthcare more consumer-directed.
Health insurance lobbyists are sharpening their knives this week in preparation for the CMS' scheduled announcement of preliminary 2016 Medicare Advantage payment rates after the markets close Friday.
Many of the new consumer-governed, not-for-profit health plans launched thanks to the ACA were in shaky financial shape in their first nine months of operation and will need to be closely monitored, raising questions about the law's method of boosting insurance competition.
Administrators and medical practice staff are knowledgeable about writing, analyzing and negotiating contracts with payers. While it's much a part of practice operations, there are still new strategies to employ when negotiating with a payer—or renegotiating with an existing payer—that...
What patients with health insurance spend out-of-pocket for a handful of common medical services varies greatly, according to a new analysis that suggests patients can benefit from shopping around but often don't because of the entrenched lack of price transparency in healthcare.