Insurers Again at Odds With Hospitals and Physicians.

Hospitals, Physicians, and Health Insurers: Guarding Against Implied Agreements in the Health Care Context

The cost of health insurance administration in California: estimates for insurers, physicians, and hospitals.

Administrative costs account for 25 percent of health care spending, but little is known about the portion attributable to billing and insurance-related (BIR) functions. We estimated BIR for hospital and physician care in California. Data for physician practices came from a mail survey and interviews; for hospitals, from regulatory reporting; and for private insurers, from a consulting company....

Improving clinical quality and sharing the profits with your physicians.

The health care industry cannot sidestep these changes. As a result, “pay-for-performance” initiatives by insurers and employers that offer some form of financial incentive to either physicians or hospitals for delivering the “right kind of care” are quickly spreading throughout the country. These initiatives, however, have not yet been applied to hospitals and physicians working together becau...

بررسی مشکل ها و مسایل موجود بین سازمان های بیمه‌گر پایه و بیمارستان های دانشگاهی: مطالعه کیفی

Objective: the aim of this study was to determine the types of relationships and problems between basic insurance organizations and university hospitals. Methods: this is a qualitative study conducted in 2010. We interviewed revenue officials of hospital and resident representatives of insurance organizations in nine hospitals affiliated to the Tehran University of Medical Sciences using semi-s...

Obamacare: what the Affordable Care Act means for patients and physicians.

The Affordable Care Act's core achievement is to make all Americans insurable, by requiring insurers to accept all applicants at rates based on population averages regardless of health status. The act also increases coverage by allowing states to expand Medicaid (the social healthcare program for families and people with low income and resources) to cover everyone near the poverty line, and by ...