Evolent's technology and consulting platform can help identify high-risk patients by analyzing data from multiple sources and then create physician-driven care-management plans.
The health insurance mega-mergers proposed nearly a year ago may be entering their final months of regulatory review, and the road ahead could be rough.
A new bill making the rounds on Capitol Hill has a hospital-centric theme. But private Medicare Advantage insurers with bad quality ratings would also benefit from one surreptitious provision.
The nation's top healthcare leaders overwhelmingly back the Affordable Care Act and support its goal of pushing providers away from fee-for-service medicine and toward delivering value-based care, according to Modern Healthcare's second-quarter CEO Power Panel poll.
As hospital margins on traditional fee-for-service Medicare patients plunged deeper into the red, cost-cutting at hospitals has allowed many to make up those losses from their commercially insured clientele.
Humana may exit some individual exchange states in an effort to stop losses tied to the new Affordable Care Act policies, the insurer said Wednesday. Humana also continues to reel after losing a large Medicare Advantage employer account.
The CMS has started to answer the many questions surrounding how physicians will get paid under the Medicare Access and CHIP Reauthorization Act. But some stakeholders were immediately dissatisfied with what they saw, and the 963-page rule may have raised as many questions as it answered.
The skeptics were out in force last week when the CMS launched a major expansion of its comprehensive primary-care initiative. They are way off base.
Last fall, Karen Ignagni took over as CEO of EmblemHealth—a financially troubled New York insurer with 3.2 million covered lives—after 22 years at the helm of America's Health Insurance Plans. She recently discussed the challenges she faces in her new position.
Did the Obama administration indulge health insurance companies with friendly changes to Medicare Advantage rate policies for 2017? Or did CMS officials stick to their guns on proposals the industry aggressively lobbied to kill? Experts say it was a little of both.
The federal government has lowered average pay raises for 2017 Medicare Advantage plans, and it also modified several of the program's policies after weeks of unremitting lobbying from the health insurance industry.
This month, longtime Sentara Healthcare Chief Operating Officer Howard Kern took the reins from CEO David Bernd, who served 43 years at Sentara, including 21 as CEO. Editor Merrill Goozner spoke with Kern about the transition and the constant challenge of improving clinical quality.