As the CMS seeks to simplify the application process for exchange plans and Medicaid, payers want to make it harder for individuals to sign up after open enrollment ends. Meanwhile, advocates and providers want to reduce barriers and have the CMS learn more about who is signing up, including their...
Regarding the Feb. 1 editorial “The future of employer-based insurance,” finally a rational discussion about this fundamental flaw in our system. There are numerous reasons why we don't need employers picking health plans for their employees, but we do need their money, which in reality...
More than a dozen major healthcare organizations and associations have jumped into a Supreme Court case over the validity of a legal theory now used to bring many fraud lawsuits against them.
Tufts Medical Center reported a drop in its operating surplus for fiscal 2015, as the not-for-profit saw a rise in total operating expenses.
Pediatricians in an ACO who received small incentives to improve quality did so, but not as significantly as doctors employed by a hospital, a new study found. The findings underscore the challenge that policymakers and the industry face as payers increasingly seek to tie payment to performance.
In 2014, Maryland started to regulate hospital spending after nearly four decades of setting hospital prices for all payers, public and private, giving other states a blueprint for aggressively regulating the way hospitals do business. But following it would require significant political will.
The American Society of Clinical Oncology says so-called clinical pathways created and distributed by payers and for-profit firms are laden with inadequacies and conflicts of interest.
One of the nation's leading endocrinologists warns that a so-called "artificial pancreas" touted as a game-changer for the treatment of diabetes could also bring headaches to the industry as it learns how to get reimbursed for advice given in between visits.
Revenue growth coupled with tight cost controls meant higher 2015 surpluses for New Hanover Regional Medical Center in Wilmington, N.C., and Delta Regional Medical Center in Greenville, Miss.
As the holiday season shifts into high gear, an ever-increasing number of consumers go online to find the best deals and enjoy the convenience of shopping from their computer, phone or tablet. Why can't health care be like that?
With enrollment surpassing 3 million, the CMS' top official defended the long-term viability of federal and state marketplaces as major insurance companies continue to highlight bleak financial performances for their products on exchanges.
The for-profit healthcare sector outlook is stable, but companies are under continued pressure to prove their value or risk becoming political targets, Fitch Ratings said in a new report.