A surge in spinal fusion procedures has brought mounting scrutiny on providers. Now payers appear poised to crack down on needless procedures by applying coverage pressure on physicians.
Insurers operating on the public insurance exchanges for individuals will be filing proposed 2015 premium rates over the next month. Early data out of Washington State indicates that anxiety over double-digit rate increases may be unfounded.
CMS officials say they are making changes to the HIX risk corridors program to account for "unexpected administrative costs and pricing uncertainties."
Evergreen Health is the only health insurance cooperative that employs physicians itself rather than link to provider networks. Evergreen embraces telemedicine and offers a wide range of services through primary care medical homes...
A multidisciplinary medical task force of the North American Spine Society is recommending best clinical practices for more than a dozen spinal treatments, surgical procedures, and diagnostics. The information is being shared with health plans.
At least $42 billion of the $2.8 trillion US healthcare industry is up for grabs as new market entrants from Walmart to technology start-ups seek a slice of the pie, according to a new study.
Highmark, the Pennsylvania-based integrated healthcare network, seeks to use ACOs and primary care medical homes to transform the way it does business.
A survey designed to measure the level of trust that hospital executives have in health insurance companies finds several factors that contribute to low scores, including the length of time it takes for claims to be paid, and the rates hospitals and physicians are paid...
For the past decade, healthcare providers have been in the vanguard of efforts to combat the abuse and diversion of opioid pain medications such as Oxycontin. Now state and federal officials and health plans are joining the fray...
The impact of proposed changes to Medicare's Inpatient Prospective Payment System in 2015 will vary from hospital to hospital, but federal officials predict providers will take a $241 million payment hit next year.
