Health insurance plans serve as the financial backbone of health care, functioning as the crucial link between employers and providers in the $2.5 trillion industry. Topics include: claims management systems, quality improvement programs and claims processing standards.
Last summer, as part of its Whats Your Healthy? national campaign, Aetna launched the CarePass consumer website and mobile solution. Now, a year later, the insurer has decided to phase out CarePass by the end of 2014.
The National Institute of Standards and Technology has issued a draft vetting guide to aid in testing mobile applications to find security vulnerabilities in them, and is accepting industry comment on the guide through Sept. 18, 2014.
The Centers for Medicare and Medicaid Services does not have reliable data nor provides sufficient oversight to measure and prevent payment contractors--particularly Recovery Audit Contractors--from conducting certain duplicative post-payment claims reviews.
Medicaid enrollees visit the emergency department appropriately like most patients, but they have generally more complex health needs and less access to primary care than their privately insured counterparts.
Telemedicine has the potential to deliver more than $6 billion a year in healthcare savings to U.S. companies, according to an analysis by global professional services company Towers Watson.
Wellness and rewards program HumanaVitality has released its first mobile application, providing a new wellness tool to the increasing number of members using smartphones to manage their health and fitness progress.
Engagement platform vendor Change Healthcare's latest quarterly Healthcare Transparency Index (HCTI) reveals that the widest variation in costs for selected inpatient procedures and imaging services is found among the facilities where the procedure or service is performed--not among the professionals who performed them.
Reps. Diane Black (R-Tenn.) and Earl Blumenauer (D-Ore.) have introduced the Value-Based Insurance Design (VBID) for Better Care Act of 2014, a measure that would establish a regional demonstration program for high-quality Medicare Advantage plans to utilize V-BID to reduce the co-payments or coinsurance for beneficiaries with specific chronic conditions.
Two big health insurance rivals in California are jointly betting $80 million that they can significantly accelerate health information exchange in the nations most populous state.
In a final rule setting 2015 payment rates for skilled nursing facilities, the federal government reiterates a commitment to accelerate SNF use of health information exchange technology.
The Centers for Medicare and Medicaid Services is restarting the controversial Recovery Audit Contractor Programin a limited fashionin August.
Talent recruitment and retention is a growing challenge for healthcare organizations around the world because of lower overall birthrate, leading to fewer potential workers, and Baby Boomers reaching retirement.
Providers have ideas for software vendors and regulators on how to make the next stage of meaningful use a bit more realistic.
Small physician practices using telemedicine can make quality care more accessible to patients in underserved communities, but numerous barriers are preventing the technology from realizing its potential, according to a July 31 congressional hearing.
Four months after President Obama signed into law a one-year delay in the ICD-10 code switchover, the Centers for Medicare and Medicaid Services has announced a final rule establishing October 1, 2015, as the new ICD-10 compliance date.