Out of Network Claims Market Gets More Interesting: Cedars-Sinai, UCLA Dropped by Anthem

Out of Network Claims Explained One of the most significant inefficiencies in health care is the pricing strategy of health plans regarding their policy on reimbursement for members who receive…

Continue ReadingOut of Network Claims Market Gets More Interesting: Cedars-Sinai, UCLA Dropped by Anthem

Does a Flaw in the ACO Business Model Leave out the Patient? Yes. Here’s Why.

January 2010 While federal legislation focuses on payor/provider synergies, there is nothing in the mandated programs beyond pilot projects or experiments according to the legislative texts. According to ATUL GAWANDE, writing for…

Continue ReadingDoes a Flaw in the ACO Business Model Leave out the Patient? Yes. Here’s Why.