Providers and insurers are among healthcare leaders lobbying Congress and the Trump administration to continue to push Medicare into value-based payment models that require costly technology to track quality metrics. Those investments could be lost if the models end.
The program is modeled after a similar one from Maryland that covers only hospitals. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.
Modern Healthcare Midwest Bureau Chief Bob Herman recently interviewed Mark Merritt, CEO of the Pharmaceutical Care Management Association, the PBM trade group, to get his take on the issues facing the industry.
HHS has announced the winners of a contest challenging designers to leverage technology to make the inscrutable – the basic healthcare explanation of benefits – so easy to read even a human being can comprehend it. Several hospitals around the country will test the designs.
Expansion of Medicaid in the 19 states that have not already done so should be a healthcare priority of the next president and Congress, a panel of healthcare policy experts told a breakfast audience Thursday of the Nashville Health Care Council.
Consolidation in the insurance industry means Medicaid beneficiaries have fewer coverage options under managed care, according to a new analysis from PWC.
Following the exodus of UnitedHealthcare and Aetna from insurance exchanges established by the ACA, President Barack Obama met Monday with the heads of some of the remaining payers to discuss the future of the federal insurance marketplace.
California medical consumers will enjoy strong new protection against surprise out-of-network medical bills starting next July, under a hard-fought bill overwhelmingly approved by the state legislature this week. It's widely expected that Democratic Gov. Jerry Brown will sign it.
The ability to mine data to forecast probabilities and trends, and ultimately manage risk, is possible through predictive analytics and the professionals who make this possible.
Xerox conducted a study with over 750 U.S. adults who are healthcare decision makers. Get the latest insights on what consumers want in the new healthcare economy.
Under value-based healthcare, providers are compensated for healthy outcomes rather than each service provided. Hear what healthcare experts have to say.
Thank you for the April 25 cover story “Breaking the system,” drawing attention to how state budget battles are preventing numerous citizens from accessing services that are integral to their health and well-being. We've noticed the same trend in instances where healthcare overlaps with...