Payers

News

CMS Database Fails to Accurately Track RAC Activity

August 14, 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 Patients Not Overusing Emergency Departments

August 14, 2014 - 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 Could Yield $6B Annually in Healthcare Savings

HumanaVitality Releases Mobile Wellness App

Facility Fees Are Wild Card in Cost Variations

Bill Authorizes Value-Based Medicare Advantage Demo

California Payers Bet $80M on Statewide HIE

CMS Gives a Push to Skilled Nursing HIE

CMS Restarts Parts of the RAC Program

Small Physician Practices Face Barriers in Using Telemedicine

Feature Articles

A New Path For Health Care

May 1, 2011 - Nothing is easy in health care communications, but a federal initiative could spur a makeover in data exchange.

My Two Cents

The Medical-Loss Ratio Conundrum

April 20, 2011 - Since I wrote my last blog regarding the confusion that I have with the whole medical-loss ratio mandate, I have been inundated with e-mails and phone calls.

Case Study

Getting Ready for Accountable Care Organizations

April 1, 2011 - Providers are gearing up for new ways to deliver and pay for care while still waiting for details.

Special Report

Overcoming ICD-10 Hurdles

May 1, 2011 - Providers and payers are getting serious about ICD-10, and experienced hands offer some practical advice for taking on the new code set.

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