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Latest Headlines

How BCBS is transforming its payment model

Blue Cross and Blue Shield companies understand that transforming the healthcare reimbursement system depends not just on cutting costs but, rather, reinventing how doctors and providers are paid.

Aetna eyes Humana's value-based care potential

The health insurance industry's latest overhaul to shift away from paying for volume to paying for value may be behind  Aetna's rumored deal to acquire either Cigna or Humana. 

Scorecard: 42 percent of Medicare payments tied to value in 2013

Of $360 million in Medicare fee-for-service payments in 2013, 42 percent were value-based,  according to an independent scorecard from nonprofit Catalyst for Payment Reform.

Payers positioned to lead alternative payment model transformation

Earlier this year, the  Department of Health and Human Services announced it would fundamentally reform how it pays providers for treating Medicare patients.  FierceHealthPayer  spoke with three industry executives at two insurance companies to discuss payers' role to align with providers to meet this goal. 

Humana CEO Bruce Broussard: 'Health should be easy'

Humana has its eyes set on a healthy task: To make the communities it serves 20 percent healthier by 2020.  The insurer plans to move from its traditional role of having an episodic relationship with its members to a role that focuses on getting people healthy, Humana CEO Bruce Broussard  wrote in a guest post for  Forbes.

There's one major problem with the HHS plan to speed up value-based performance

Last month, the  Department of Health and Human Services announced that it would fundamentally reform how it pays providers for treating Medicare patients in the coming years. it's a positive move, but there  is one potential flaw: The plan relies on the success of accountable care organizations--success that has yet to be achieved fully.

Anthem, insurers on board for value-based payments

As new payment methods gain traction, the nation's second-largest insurer is taking leaps and bounds to transition away from the traditional fee-for-service model toward value-based payments.

North Shore-LIJ CEO Michael Dowling on value-based reimbursement, growing market share

CareConnect, a health insurance company created by New York City-based healthcare group North Shore-LIJ Health System last year, is building its performance-based reimbursement model--and its market share.

Illinois Medicaid lowered costs with enhanced fee-for-service model

As insurers continue the shift toward value-based reimbursement, two Medicaid health plans improved members' health outcomes and lowered costs by combining value-based payments with a fee-for-service approach.

Access to hospital beds may lead to overtreatment, unnecessary care

More people in New York and New Jersey die in the hospital because the region has more than enough beds to offer, leading to more tests, treatments and prescriptions and people dying in the intensive care unit on a feeding tube or a ventilator,  Kaiser Health News,  National Public Radio  and  WNYC  reported.