Health payers are often looking for ways to reduce healthcare spending, especially with regard to the costs of covering medical claims. Many have focused on implementing value-based care reimbursement...
While value-based care payments are making headway across the country, there are still barriers that stand in the way of payers and providers fully embracing these alternative payment models. A report...
Consumer choice in health plans and provider networks is becoming a more popular topic of late among payers looking to increase patient engagement. There is a growing movement around the nation aimed...
The major health insurance mergers taking place between Anthem-Cigna and Aetna-Humana have shown some progress of late. Recently, the Indiana Department of Insurance approved the acquisition between...
The health insurance industry may have a complete transformation on their hands with regard to hospital and medical practice reimbursement. The number of provider-sponsored health plans is growing...
A major goal among health payers today is to decrease continually rising healthcare spending. One way to do so is to identify patients who are at higher risk of deteriorating medical conditions and...
In the state of Missouri, policymakers issued an order that would prevent the Aetna-Humana acquisition from proceeding in post-merger activity within Missouri's Medicare Advantage plans as well as...
The Healthcare Effectiveness Data and Information Set (HEDIS) is used by more than 90 percent of all health plans situated around the country to compare performance and year-to-year success. HEDIS...
Earlier this month, the mobile technology company athenahealth released its annual PayerView Report, which delves into the complex and evolving relationship between payers and providers, according to a...
The healthcare insurance industry needs to meet the demands of consumers looking for quality provider data. Patient-centered medicine is becoming a mainstay throughout the country and cost transparency...
Both public and private health payers have been searching for ways to reduce healthcare spending as a whole, but rising prices may be making it more difficult to combat medical care expenditure. The...
The health insurance industry has been changing due to the Affordable Care Act and other regulatory pressures from the Centers for Medicare & Medicaid Services (CMS). Rising healthcare costs along...
Those who have spent time in a doctor’s office or emergency room may have seen that the prices of healthcare services tend to vary drastically among separate medical facilities. New findings from...
Is healthcare spending in the United States too high? Are the financial aspects of running the medical system around the country burdening the US economy? The National Center for Policy Analysis...
One medical claims processing technological project has been put to rest in the state of California. This project began in 2007 and has still failed to be completed, according to the California...
If health insurance companies truly want to improve patient health outcomes including the quality of care and boost patient safety in an effort to reduce wasteful spending, it may be beneficial for...
The health insurance industry could benefit from greater cost transparency, as it could bring new methods for lowering healthcare spending and create a more competitive market among providers. Federal...
The US healthcare system is one of the most expensive around the world and the rising costs haven't diminished significantly in recent years. Today, health payers and providers have been working...
Due to the value-based care initiatives taking place at the Centers of Medicare and Medicaid Services (CMS), patient engagement and patient satisfaction have become imperative for the health payer...
In today’s world, the average employee and business owner are seeing a rise in health insurance costs. Even through the health insurance exchange, premium prices are expected to rise this year...