Accountable care organizations run by private insurers have matured in their efforts to boost quality and lower costs, but shared risk plays an increasing role in changes to reimbursement models, according to an analysis from the American Journal of Managed Care.
Aetna has merged its health app-maker subsidiary, iTriage, with its cost transparency business, WellMatch, to form one group, according to MobiHealthNews.
Predictive analytics are supposed to be the key to preventing healthcare fraud, but as the latest investigation into compounded pharmaceuticals shows, the industry is still a long way from effectively preventing improper payments. Although the signs of abuse were there, government officials employed a long-standing "Whac-A-Mole" approach to enforcement of compounded drugs, leaving investigators to try to claw back millions of long-gone payments.
Individuals working in the healthcare industry could learn a lot from the hospitality/gaming industry, according to Aetna Vice President of Consumer Health & Sciences Gary Loveman.
Despite recent critical remarks that diverged from his otherwise optimistic view of the Affordable Care Act marketplace, Aetna CEO Mark Bertolini says in an interview with Kaiser Health News that he does indeed support the exchanges and wants to work with the Obama administration to improve them.
Despite potential hurdles, numerous payer-provider collaborations already serve as success stories for care quality improvement. In this special report, FierceHealthcare takes a look at two successful partnerships among providers and payers that have led to improved patient outcomes and patient engagement.
The Core Quality Measure Collaborative's unveiling of a standardized set of quality benchmarks represents a major milestone for a healthcare industry that too often struggles with burdensome reporting requirements. But the process to achieve this long-sought set of measures wasn't easy, nor is the work finished, Andrew Baskin, Aetna's national medical director for quality and provider performance measurement, tells FierceHealthPayer in an exclusive interview.
Leaders from across the industry have identified six "common-sense solutions" to improve the U.S. healthcare system, touching on subjects including data interoperability, Medicare payment policies and care of chronically ill patients, according to a report released Wednesday.
Four keynote speakers, including Aetna Executive Vice President Gary Loveman, will headline the College of Healthcare Information Management Executives' annual CIO Forum in Palazzo Ballroom D on...
The recent performance-based deal that Novartis cut with two insurance giants could signal the beginnings of a new approach to drug pricing, according to a Bloomberg editorial.