Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Does Medicare Advantage Bidding Hold the Key to Reducing Costs?

    December 14, 2018 - In light of future research on Medicare Advantage spending compared to Medicare fee-for-service, a trio of researchers writing on the Health Affairs blog see the promise in competitive bidding to drive down healthcare spending. “Overpayment of MA plans could be eliminated by basing government payments on bids submitted by both fee-for-service Medicare and MA plans to cover the...

  • Risk Scores at Center of Sutter-DoJ Medicare Advantage Dispute

    December 13, 2018 - A complaint against Sutter Health and Palo Alto Medical Foundation over appropriate risk scores has drawn the attention of the Department of Justice. The federal agency officially announced its intervention into a lawsuit that alleges that Sutter violated the False Claims Act for assigning inaccurate risk scores to its Medicate Advantage beneficiaries. “Federal healthcare...

  • BlueCross BlueShield Strikes Deal to Improve Health Data Exchange

    December 13, 2018 - In an agreement that will support physicians and upgrade health outcomes for its members, BlueCross BlueShield of Western New York has announced a partnership with HEALTHeLINK. It will enable local participating physicians to access specific claims data through the organization’s transparent and secure data exchange platform. By doing so, it will allow local physicians to...

  • Employers to Address Healthcare Consumerism, Innovation in 2019

    December 11, 2018 - The National Business Group on Health has released its top-five trends for the coming year, and employers clearly want to play a more involved role in healthcare transformation. Chief among their expectations over the next twelve months in playing a more vocal role in determining the right suite of benefits for their employed population. “The pace of meaningful and sustained...


Today's Top Stories

Does Medicare Advantage Bidding Hold the Key to Reducing Costs?

In light of future research on Medicare Advantage spending compared to Medicare fee-for-service, a trio of researchers writing on the Health Affairs blog see the promise in competitive bidding to drive down healthcare...

Risk Scores at Center of Sutter-DoJ Medicare Advantage Dispute

A complaint against Sutter Health and Palo Alto Medical Foundation over appropriate risk scores has drawn the attention of the Department of Justice. The federal agency officially announced its intervention into a lawsuit that alleges...

BlueCross BlueShield Strikes Deal to Improve Health Data Exchange

In an agreement that will support physicians and upgrade health outcomes for its members, BlueCross BlueShield of Western New York has announced a partnership with HEALTHeLINK. It will enable local participating physicians to access...

PwC: Digital Experiences, High Costs Will Challenge Payers in 2019

Healthcare payers that hope to succeed in 2019’s competitive business environment will need to meet the strong demand for more consumer-centered digital experiences that help members control their spending and understand how to...

Employers to Address Healthcare Consumerism, Innovation in 2019

The National Business Group on Health has released its top-five trends for the coming year, and employers clearly want to play a more involved role in healthcare transformation. Chief among their expectations over the next twelve months...

AHIP, Payer Groups Agree to Focus on Nixing Surprise Billing

Nine of the nation’s most influential payer organizations, including AHIP and the Blue Cross Blue Shield Association (BCBSA), have released a new set of guiding principles aimed at eliminating surprise billing. Unexpected medical...

Health Payers Targeting Improved Consumer Experiences in 2019

Improving the consumer experience is top of mind for health payers heading into the new year, according to a multi-industry survey of senior leaders by North Highland. “The concepts of culture and change are often at the foundation...

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