Latest Headlines

Latest Headlines

IDC: Payers need to better understand the overall consumer population

The success of certain areas in the health insurance industry--namely, the individual insurance exchange, Medicaid, Medicare and dual eligibles--depends on payers' ability to better understand the overall consumer population.

Medicare to start paying doctors to administer better care

Medicare will now issue a monthly fee to primary care doctors with the intention to provide better care to seniors who need it most.

Study: Most Medicare Advantage members come from Medicare

Medicare Advantage is an increasingly popular choice among eligible consumers--including those who are already enrolled in traditional Medicare. In fact, at least half of new Medicare Advantage enrollees switched from Medicare each year.

Insurers hesitant to cover costly anti-obesity drugs

Many insurers are reluctant to cover weight-loss drugs--and the reason why has changed.

Medicare Advantage plans could lose members to feds

If Medicare Advantage plans drop significant amount of providers from their networks, their affected members can leave those plans and enroll instead in traditional Medicare.

What caused the Medicare spending slowdown?

Back in 2009, the Congressional Budget Office predicted that Medicare spending would be $706 billion in 2014. But spending will end up amounting to $580 billion.    A number of factors contributed to this  $126 billion gap, according to a new analysis from the Kaiser Family Foundation.

CMS to hit 257,000 docs with Meaningful Use penalties

Roughly 257,000 Medicare eligible professionals (EPs) will be hit with a 1 percent penalty to their Medicare Physician Fee Schedule payments beginning  Jan. 5, 2015, for failing to meet Meaningful Use by Oct. 1, 2014, the Centers for Medicare & Medicaid Services revealed during a press call on Dec. 17. Of those 257,000 EPs, 28,000 will receive a 2 percent penalty for failing to meet an e-prescribing threshold.

Patient's employment status plays big role in readmission

Socioeconomic factors such as employment status are some of the biggest factors impacting the odds of a patient's readmission, according to a new study by Truven Health Analytics.

Place the blame for high hospital prices squarely on deregulation

"That government is best which governs least" is a quote attributed to founding father Thomas Jefferson. Even if Jefferson almost certainly did not say or write those words, it has been...

AHA chimes in on clearing up RAC backlog

The American Hospital Association has appealed directly to the chief administrative law judge of the Office of Medicare Hearings and Appeals to assist in reforming a system currently overloaded with appeals of recoupments made by recovery audit contractors (RAC).