Billions of Dollars Flow into Private Medicaid Plans with NO Cost Oversight or Efficacy of Treatment Determined

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Cost containment has become a leading factor in the delivery of healthcare. What are some of the issues that are contributing to these burgeoning costs? One of them is Medicaid. We spent over $576 billion on Medicaid programs in 2017, as reported by the Kaiser Family Foundation.

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Walmart Reportedly in Early-stage Talks to Buy Humana

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Here we go again! In my last blog I mentioned how companies like Amazon, Google, Apple, Uber, etc. will be driving innovations in healthcare delivery and costs over the next 10 years. Today, the Wall Street Journal (WSJ) reported that retail giant Walmart is in preliminary talks with health insurer Humana about developing a closer partnership, with one possibility being that Walmart might acquire Humana.

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Medicare Advantage Growth Could Spell Problems for Providers

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Medicare Advantage (MA) business continues to experience significant growth, increasing demand for MA plans. Despite the uncertainty surrounding health care and proposed budget cuts to the program, Medicare Advantage enrollment continues to climb and this trend is expected to continue throughout 2017 and beyond. As of February 1, 2017, total Medicare Advantage membership stood at 19,593,341, with a net gain of 1,389,665 members, year-over-year.

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Medical Coding Risk Adjustment and Physiciansโ€™ Pay by Nitin Thakor, President and CEO, GeBBS Healthcare Solutions

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A recent article in Neurology Today covered the story of how a federal lawsuit is claiming that UnitedHealth Group (UHG), the nation's largest Medicare Advantage insurer, is inappropriately coding medical…

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