As more Americans gain Medicaid coverage, investing in a health plan is a potential lifeline for urban safety net systems. In Chicago, the Cook County Health and Hospitals System and its patients have both seen their health improve with CountyCare, the system's Medicaid managed-care plan.
UnitedHealth Group's announcement this month that it will consider exiting the insurance exchanges in 2017 because of sizable financial losses on its exchange business was the latest in a series of blows to the Affordable Care Act.
Cincinnati-based Mercy Health and Akron, Ohio-based Summa Health will jointly contract for accountable care with health plans under a newly created clinically integrated network with broad geographic reach in the state.
Medicaid agencies want federal officials to keep them in mind as they incorporate participation in alternative payment models with all types of payers into Medicare's reimbursement rates for physicians.
Federal prosecutors announced charges Tuesday against a former hospital CFO, two surgeons and two other defendants in a kickback scheme involving nearly $600 million in fraudulent claims for spinal surgeries in Southern California.
The Democratic presidential candidate laid out his health policy plan Tuesday in an effort to energize his struggling campaign.
The CMS wants more information about the quality of care Medicare beneficiaries get in long-term-care hospitals, so the agency is preparing a new patient-satisfaction survey tailored to the facilities.
The CMS halted all enrollment in a program that cares for poor seniors at Alexian Brothers Community Services in St. Louis. The agency found Alexian failed to provide necessary services and avoided enrolling sick, more expensive patients.
Health plans say they are unsure when they will be able to fully comply with a proposed rule that bans healthcare-related discrimination against transgender people.
Hospitals in more than five dozen metropolitan areas will soon have no choice but to take bundled payments from Medicare for hip and knee replacements. And the skilled-nursing facilities that do business with them face a stark reality of their own.
Attorneys predict that more False Claims Act cases alleging Stark violations are on the horizon partly because two giant cases, involving Tuomey Healthcare System and Halifax Health, alerted potential whistle-blowers inside hospitals to the riches they could pocket.
An HHS forum on prescription drug prices kicked off Friday with a discussion on balancing pharmaceutical innovation with patient access and affordability.