With CMS payments for clinical testing in decline, and continued pressure to shift from volume to value payment models, healthcare leaders looking to maintain fiscal health at their organizations should to take steps to optimize the value generated by labs.
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Aetna reached an agreement to improve its provider directories after a Massachusetts attorney general investigation uncovered inaccuracies in its network information, according to The Boston Globe.
New York City-based health insurer EmblemHealth agreed to pay New Jersey $100,000 to resolve allegations it disclosed the personal information, including Social Security numbers, of more than 6,000 residents, according to the New Jersey Division of Consumer Affairs.
The prospect of paying higher health insurance premiums is more of a concern to Americans than paying medical bills or being denied coverage due to a pre-existing condition, according to a recent Gallup poll.
UnitedHealthcare and Nashville, Tenn.-based Envision Healthcare, one of the country's largest providers of emergency room services, agreed to extend their contract, effective Jan. 1.
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Nearly three-fourths, or 72 percent, of health plans sold on the 2019 ACA marketplace have narrow physician networks, according to an Avalere study.
The first study to show a causal relationship between the ACA's health insurance subsidies and financial stability has been provisionally accepted by the Journal of Public Economics, according to a report from CityLab.
Tupelo-based North Mississippi Health Services is set to go out of network with Humana's Medicare Advantage plans Jan. 1, according to the Daily Journal.
Members of Toledo, Ohio-based ProMedica Physician Group said low rates are the main sticking point in an ongoing contract spat with Aetna, according to The Blade.
CMS issued a final rule to continue its risk adjustment program for the 2018 benefit year.