Business Strategy

Few providers or commercial payers have fully addressed implementing ICD-10

Aging baby boomers will bring more people into Medicare, while reform will expand Medicaid

The theory behind the model is that care can best be provided by a team of clinicians

Beyond basic compliance with the regulations, the market fallout could be anything from a pin drop to a sonic boom

Incentives for large employers to offer coverage are still there

Most existing benefit plans will lose their grandfathered status by 2019, according to observers

Many fear that the $5 billion allocated by the federal government for high-risk insurance pools won't last until 2014

A cumulative 23% cut is scheduled for this December. Another 6.5% cut in January 2011 and a 2.9% cut in January 2012 are scheduled.

The stimulus package provided more than $1 billion in federal support for comparative effectiveness research (CER), which has the potential to improve clinical decision making

The significant challenges facing insurers include minimizing disruption and mitigating the impact on cost

The health reform law will be moderately successful, but it's only going to get half the job done

Conventional wisdom says families should set aside an emergency fund for unexpected expenses, however, one consumer group is recommending that health insurers' emergency funds should be rigorously examined.

Exchanges could bring in millions of potential customers. Insurers need to begin formulating marketing plans now.

Whether you're moving forward with an acquisition, with a sale or by outsourcing, remember some things will never change.

Accountable care organizations have become a hot commodity since the Patient Protection and Affordable Care Act opened the door for health plans to contract through an ACO for commercial enrollees. The momentum of ACOs will likely increase.

According to several presenters at the recent America's Health Insurance Plans Institute, coordination, communication and challenges are now the industry's driving forces.

While medical science has steadily improved mortality overall, the research suggests that limited access to healthcare services in rural areas creates a gap.

Policymakers are now revisiting the Massachusetts model to evaluate the results. According to most experts, the state is providing a grim wake-up call to the rest of the nation.

It is possible for hospitals to provide high value to Medicare and commercial payers.

As with any significant market regulation, the provisions in healthcare reform will undoubtedly change over time.

The rapidly approaching shift from ICD-9 to ICD-10 is a massive system overhaul that many have underestimated.

Physician assistants (PAs) and nurse practitioners (NPs) could solve the shortage of primary care physicians and the rising cost of healthcare.

It's intuitive that preventing a problem from happening is preferable to fixing it after the fact.

Blue Cross Blue Shield of Michigan and 15 hospitals will embark on a statewide project in May to cut the millions of dollars spent on preventable hospital readmissions.

A health plan's approach to provider reimbursement is rooted in the need to move from traditional fee-for-service models to a payment model that accounts for providers adhering to best practices.