Health Care Delivery

The Sustainable Growth Formula (SGR) Repeal and Medicare Provider Payment Modernization Act has been framed as a bipartisan solution to establishing a permanent doc fix. The only problem, it seems, is how Congress will pay for the SGR's elimination.

The White House has decided to reverse roughly $10 billion in cuts to the cost-sharing subsidies that were part of the Patient Protection and Affordable Care Act. That program was originally expected to be slashed by 7.3 % in fiscal 2015 and beyond as part of the sequester cuts.

Criminals are stealing patient records to commit medical identity theft. And the Affordable Care Act (ACA) has made the situation worse, according to a new report from privacy and information security research firm Ponemon Institute.

Health insurance companies across the country remain wary of setting their health plan prices for the 2015 insurance exchanges due to a lack of data needed to make evidence-based decisions.

Health plans with narrow provider networks-which met with fierce backlash from patients and providers during the last go-around in the 1990s-are once again vulnerable to negative public opinion and legislative action.

Behind MNsure's upbeat facade was a swamp of management failures and technical glitches that crippled the more-than $100 million website.

Nearly 950,000 Americans selected a health insurance plan through the state and federal exchanges in February. That brought the total to 4.2 million with one month left in the open enrollment period.

he lower chamber is expected to vote on legislation that would permanently repeal Medicare's sustainable growth-rate formula for physician payment, which might also include a provision to either repeal or delay the ACA's individual insurance mandate as a way to pay for the SGR fix.

With just three weeks left to sign up under President Barack Obama's healthcare law, a major survey tracking the rollout finds that the uninsured rate keeps going down.

Just in case Congress doesn't pass President Barack Obama's fiscal 2015 budget plan, officials at the Department of Health and Human Services say they have other options for finding the money they need to implement the health care law.

Open enrollment for the 2014 state and federal health insurance exchanges will end this month, but various findings contest their anticipated success.

President Barack Obama is proposing more than $400 billion in cuts to Medicare over the next decade in his fiscal 2015 budget, an almost identical amount to what he recommended last year. But those cuts are heavily weighted toward future years, with only $3.5 billion occurring in 2015.

The Republican-led House of Representatives voted on Wednesday to delay for one year the tax penalty Americans will pay under President Barack Obama's healthcare law if they decline to enroll in health coverage for this year.

For state exchanges still struggling to function, and governors facing the consequences, the Centers for Medicare & Medicaid Services is offering an exception to the rule of tax credits only being available through public marketplaces.

Health policy advisors and advocates are shifting their focus to the possibilities of telehealth, which would allow physicians to treat patients virtually. Health experts suggest that this emerging health frontier could be promising, especially for patients who are immobilized or who live in remote locations.

The ObamaCare exchanges have reduced the choice of and increased the price of insurance polices when compared to what existed in 2013 on the individual market, says a just-released study.

It's one of the most impressive statistics about the new health care law. The Obama administration says more than 8.9 million people have been, quote determined eligible for Medicaid from Oct. 1 through the end of January.

When it comes managing the long-term care of dual eligibles, many health systems are looking toward managed long-term supports and services (MLTSS). Unlike traditional Medicare and Medicaid, MLTSS would expand managed healthcare medical services to include personal support and other assistance.

It's a simple idea, but a radical one. Let people know in advance how much health care will cost them-and whether they can find a better deal somewhere else.

Pressing for a final rush of health care enrollees, President Barack Obama said Tuesday that about 4 million people have signed up for health insurance through federal or state marketplaces set up under his health care law.

CMS intends to implement a 1.9% rate reduction in payment rates for Medicare Advantage plans in 2015. Some payers fear that number may increase as fees associated with the Affordable Care Act (ACA), as well as other policy changes, also begin to impact physician reimbursement.

Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company.

It is always important to remember that healthcare and health insurance are two very different things, and neither of them is a guarantee of good health.

Essential health benefits form a cornerstone of the Affordable Care Act. Our study shows that health plans in California and Massachusetts are not fully compliant with state and federal regulations on essential drug benefits.