Even Omada Health’s CEO Sean Duffy half-jokingly refers to the company as a provendor—a reference to the digital health company’s high tech roots melded with the billing approach of a provider (complete with an NPI). The identity has caused headaches f…
A survey from eHealth says more than half of private payers will expand their individual market offerings in 2019, and only 7% will reduce them. Plus, Medicaid isn’t meeting foster children’s complex needs. Can managed care plans help?
NAACOs found a huge difference in how much ACOs save the Medicare program—a difference that has profound policy implications, it says.
With a dedicated EHR platform through Flatiron Health, three large cancer practices are partnering to create economies of scale and push back against consolidation by pulling together more than 200 oncology providers at more than 100 care locations.
On Friday, a D.C. judge invalidated a 2014 rule that required Medicare Advantage insurers to report and return overpayments associated with incorrect diagnosis codes. The ruling could have a huge impact on an ongoing case against UnitedHealth and a fed…
The commissioners debated its details, but overall, they were enthusiastic about a proposal to redesign Medicare’s hospital quality reporting system.
Poor communication combined with a change in Social Security policy is keeping some people who are eligible for Medicare out of the program.
The commission could soon recommend a simplified, site-neutral system that would make costs more predictable and potentially pull SNFs, rehab facilities, long-term care hospitals and home health into one tiered system.
Despite enhanced guidance from CMS, nursing homes hit by disaster often struggle to execute emergency plans and protect residents, according to testimony from the HHS Office of Inspector General to lawmakers last week.
With all eyes on the ACA lawsuit in Texas, a federal judge issued an important victory for insurers over the fate of cost-sharing reduction payments. The DOJ is likely to appeal the decision.
