Under a managed care arrangement, Medicaid MCOs determine the rates they pay providers for inpatient hospital services.

Talk of "operational efficiency" and "compliance" can wear healthcare leaders down. But while industry buzzwords might be numbing your psyche, the benefits of enhancing healthcare payment workflows ...

When the CEO of United Health Care was gunned down on a city street, it is unclear whether anyone expected the massive outburst of hatred for the health insurance industry. The memes are amazingly ...

A common thread in efforts to improve the system is to become more patient-centered, as emphasized in the landmark Institute of Medicine Report, “Crossing the Quality Chasm,” nearly 25 years ago. To ...

This article is the latest in the Health Affairs Forefront series, Provider Prices in the Commercial Sector, featuring analysis and discussion of physician, hospital, and other health care provider ...

Every day, your health system makes thousands of operational decisions—referrals, scheduling, site of care, discharge planning. What if each decision could simultaneously optimize for quality, patient ...

There are 3 ways to make the US health care system more efficient and sustainable: address its burdensome complexity, emphasize primary care reimbursement, and regulate drug pricing. Moving to a ...