The No Surprises Act appears to be reducing out-of-pocket costs for consumers, with a new study from Harvard University and Mass General Brigham showing significant decreases in out-of-pocket spending ...

The House Committee on Oversight and Government Reform said last week that it’s expanding its investigation into the role of pharmacy benefit managers by seeking information about how they use foreign ...

The physician does the prescription in the background, Surescripts asks the PBM for prior auth approval and the information is pulled from the EHR, all within 30 seconds, says Matt Koehler, VP of ...

Northwestern University and Chicago-based health system Endeavor Health have developed a new computer program that can help ...

The report also sheds light on Medicare Advantage reimbursement. Medicare Advantage plans pay physicians an estimated 10% to ...

In June, CMS issued the final rule, “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability.” ...

After 12 years of litigation, Blue Cross and Blue Shield and providers have reached a $2.8 billion settlement in federal ...

About 85% of health plans have yet to centralize their data across systems, representing missed opportunities when it comes ...

Citing duplication of services, the MetroHealth System, based in Cleveland, is closing six outpatient offices this autumn as ...

Sutter Health in Sacramento, California, will establish a new cancer center in Santa Cruz on the back of a $30 million ...

As the major insurers reported their second-quarter financial results at the end of last month, a theme emerged: ...

The groups say the AHRQ’s cessation of its grantmaking process violates statutory and regulatory requirements.