Tag:
Provider Networks
Latest Headlines
Latest Headlines
CMS plans network-breadth rating system for Healthcare.gov plans
Though the federal government has stepped back from its proposal to implement additional network adequacy regulations for Affordable Care Act plans, it will move forward with its initiative to provide Healthcare.gov shoppers with information about health plans' network breadth.
3 ways payers can adapt to meet consumer expectations
With consumerism now a game-changing reality in the healthcare industry, payers must align their business strategies to focus on their customers as both members and patients, according to a new report from IDC Health Insights.
AHIP: Out-of-network bills vary greatly nationwide
The amount providers bill consumers for out-of-network care varies greatly from state to state, according to an analysis from America's Health Insurance Plans, findings the group says underscore the value of health plans' provider networks.
Provider networks can help members obtain specialty care
Insurers' provider networks can help patients obtain safe and affordable specialty care when they include a range of specialty doctor and hospital groups with a history of delivering high quality care, according to a new report from America's Health Insurance Plans.
3 key reasons CMS overhauled MCO rule
Although insurers have already begun pushing back against proposed Medicaid managed care organization regulations, the Centers for Medicare & Medicaid Services released the rule so that it could catch existing regulation up with reality.
Use of tiered networks prompts hospitals to cut prices
Hospitals now operate in a world of increasingly narrow provider networks and tiered preferences. How do those elements impact their bottom line? They take a fairly significant bite, according to a recent study conducted by Harvard University on behalf of the Commonwealth Fund.
CMS tightens provider directory rules for 2016
Starting next year, health insurers must provide up-to-date doctor lists for their Medicare Advantage and Healthcare.gov policies, according to the Centers for Medicare & Medicaid Services.
Medicare Advantage plans could lose members to feds
If Medicare Advantage plans drop significant amount of providers from their networks, their affected members can leave those plans and enroll instead in traditional Medicare.
OIG: Insurers' Medicaid provider directories are inaccurate
Medicaid insurers' provider directories include doctors who are unavailable, not accepting new patients or could not be found, says a report from the Office of the Inspector General.
Company aims to help uninsured without actually insuring them
Health insurers have lots of competition vying for the same consumers, especially in the health insurance exchanges, but one non-traditional company could be looking to compete against traditional insurers in a whole new way.
