Insurance

Associations between out-of-pocket costs and prescription reversals, as well as impact of reversals on rehospitalizations and healthcare costs, were examined among patients prescribed oral linezolid.

MedPAC, the Congressional advisory committee on Medicare, discussed how to get patients more involved in their health decisions.

Federal officials for more than a decade have let hospitals charge Medicare varying rates for certain emergency department overhead and staffing costs called facility fees-a controversial policy some critics believe invites overcharges.

Hospitals and healthcare systems nationwide are increasingly buying more physician practices as health reform requires care delivery to move toward a more quality-based care model instead of a fee-for-service one. The reactions are mixed.

Bargaining leverage, not the cost of providing complex care, is the main reason why some hospitals can demand prices twice as high as their competitors' and still get contracts to treat privately insured patients, according to a new study.

A new poll conducted by the American College of Physician Executives has found that doctors are almost evenly divided on whether or not Medicare payment data should be made public.

Darius Lakdawalla, PhD, addresses the value of diabetes patients' adherence in this clip.

The U.S. health care bureaucracy is expanding; both dramatically (e.g. the implementation of the Affordable Care Act) and gradually. A recent decision proposed by the Centers for Medicare & Medicaid Services (CMS) exemplifies the dangers to medical innovation and patients represented by the gradual expansion of the health care bureaucracy.

Debated and despised, the Medicare physician payment formula may finally be on the way out at least that's what AMA President Ardis Hoven believes.

Amitabh Chandra, PhD, says health reform affects patient-centered diabetes care through two different interventions.

Only 6 states across the country are currently receiving funds through the Affordable Care Act (ACA) provision intended to increase Medicaid managed-care payments to meet Medicare payment levels.

Medicare may enjoy the fruits of the growing and varied work among private payers and providers to boost value in healthcare, though the benefits will come sooner to costs than quality, a study suggests.

A new study from The American Journal of Pharmacy Benefits finds that physicians who treat cancer patients may be influenced by the reimbursement policies of the Medicare claim processors that pay them.

Could Medicare payment models impact a physician's decision to prescribe cancer drug supplements? A recent study from The American Journal of Pharmacy Benefits published new findings that say they can.

Facing anticipated reductions in funding and regulatory changes under the health care reform law, several of the nation's largest health insurers have indicated plans to scale back their Medicare Advantage programs.

The healthcare reform act intends to extend insurance coverage for millions of Medicare patients nationwide, but that doesn't mean it will expand their access to physicians.

Medicare accountable care organizations outnumber non-Medicare ACO contracts and make up more than half of the 488 ACOs nationwide, according to an August 2013 update from Leavitt Partners, a healthcare consultancy that follows ACO development.

The federal sequester trims Medicare payments for cancer patients receiving chemotherapy in doctors' offices in an effort to save the government money. Instead, it will end up costing more in the long run, according to the president of the American Society of Clinical Oncology (ASCO).

Critics say a Medicare loophole leaves patients on the hook for tens of thousands of dollars.

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.

Preventive health services are key to ensuring people seek care before their conditions are critical or urgent in nature. As healthcare services for Medicaid and Medicare beneficiaries expand under the Affordable Care Act, so will the need for professionals who can administer certain preventive measures.

A new analysis from HealthPocket of Medicare drug plans reveals that in both traditional Medicare and Medicare Advantage plans, consumers face various hurdles in accessing their medications.

In an effort to offset cost increases associated with the Affordable Care Act (ACA), the Obama administration intends to expand hospitals' access of the 340B discount drug plan. While the expansion may sound promising to some, many others worry that the program will threaten the quality of care, as increased participation risks higher potential for abuse. Even worse, the 340B program will likely rise the cost of cancer care.

Recovery Audit Contractors (RAC) out to identify improper payments made on claims for Medicare beneficiaries

The Centers for Medicare & Medicaid Services Innovation Center held an Open Door Forum on Aug. 1 to announce some modifications to the application for the Comprehensive ESRD Initiative, or renal-specific Accountable Care Organization demonstration.

Medicare will levy $227 million in fines against hospitals in every state but one for the second round of the government's campaign to reduce the number of patients readmitted within a month, according to federal records released Friday.

On July 8, 2012, the Centers for Medicare & Medicaid Services (CMS) released two major Medicare proposed rules impacting payment for physician and hospital outpatient services in 2014. ASH will submit comments to CMS on the proposed rules by the September 6 deadline and would like to incorporate feedback from the Society's practice-based members.

The Obama administration says the average monthly premium for Medicare prescription drug plans will inch up by $1 next year, to $31.