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There's a new drug regimen being touted as a potential cure for a dangerous liver virus that causes hepatitis C. But it costs $84,000 -- or $1,000 a pill. And that price tag is prompting outrage from some consumers and a scramble by insurers to figure out which patients should get the drug -and who pays for it.

Genetic counseling-including testing and risk assessment-is one of the most rapidly growing areas of oncology and has become the standard of care for patients with a personal and family history of breast, ovary, or colon cancer.

Those with chronic illnesses such as leukemia, hepatitis C, and multiple sclerosis may face a significant increase in their out-of-pocket expenses for specialty drugs. This is because payers are replacing fixed-dollar copayments with coinsurance rates that require patients to contribute a higher percentage of the cost for their specialty medications.

When it comes managing the long-term care of dual eligibles, many health systems are looking toward managed long-term supports and services (MLTSS). Unlike traditional Medicare and Medicaid, MLTSS would expand managed healthcare medical services to include personal support and other assistance.

Although highly touted, the patient-centered medical home model failed to lower use of services or total costs and produced little quality improvement over three years, research has found.

The federal government's top health official Thursday gave U.S. healthcare innovation a grade of Incomplete.

Session highlights from the Managed Markets Summit in Orlando, FL, February 25-27.

Doctors and other health providers wrote about 11 million fewer prescriptions for narcotic painkillers in 2013 than in 2012, but some experts expected a bigger drop-off given the brighter spotlight on the nation's opioid epidemic.

It's a simple idea, but a radical one. Let people know in advance how much health care will cost them-and whether they can find a better deal somewhere else.

The cost of new hips and knees for privately insured patients varied widely across three dozen hospitals in six states, with hospitals themselves the primary reason, a study shows.

Pressing for a final rush of health care enrollees, President Barack Obama said Tuesday that about 4 million people have signed up for health insurance through federal or state marketplaces set up under his health care law.

A patient-centered medical home (PCMH) demonstration project did little to reduce costs and utilization or improve the quality of care, researchers found.

Session highlights from the Managed Markets Summit in Orlando, FL, February 25-27.

Blue Cross Blue Shield of Michigan has expanded its value-based hospital reimbursement model with 5 more health systems in the state, representing 24 hospitals, for a total of 7 systems.

CMS intends to implement a 1.9% rate reduction in payment rates for Medicare Advantage plans in 2015. Some payers fear that number may increase as fees associated with the Affordable Care Act (ACA), as well as other policy changes, also begin to impact physician reimbursement.

Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company.

In a rare display of bipartisanship, key committees of both houses of Congress are backing legislation that would permanently erase the sustainable growth-rate formula, a poorly thought out payment reform measure that for more than a decade dictated sharp cuts in Medicare physician pay.

Nationwide, health systems, including hospitals and accountable care organizations (ACOs), are increasingly expanding their provider networks to include more physician groups.

It's a simple idea, but a radical one. Let people know in advance how much health care will cost them-and whether they can find a better deal somewhere else.

Federal officials issued the first set of voluntary standards under a new process that will give companies that develop electronic health-record systems more notice about what requirements will be included in the federal rules governing their products.

Medicare is proposing a small cut in Medicare Advantage rates for 2015, less than half of what private insurers were expecting from the federal agency. The final rule will be released April 7.

It is always important to remember that healthcare and health insurance are two very different things, and neither of them is a guarantee of good health.

Congress should extend funding for the Children's Health Insurance Program because millions of lower-income children could lose coverage if the program ends next year, members of the Medicaid and CHIP Payment and Access Commission said Thursday.

A 4-year study assessing the impact of early outpatient palliative care versus standard oncology care in a variety of advanced cancers found promising results. The researchers observed that when palliative care teams collaborated earlier in the course of illness, it improved patients' quality of life and satisfaction.

Belgian cancer testing group MDxHealth recently announced an agreement with US health organization Prime Health Services to extend access to its prostate cancer test to 144 million insured people. MDxHealth suggests that collaboration will permit faster reimbursement for cancer testing.

The CMS will offer end-to-end testing of Medicare claims using the ICD-10 diagnostic and procedure codes, an attempt to deliver much sought-after assurances that its contractors will be prepared for the Oct. 1 implementation date.

It's called patient dumping when hospitals transfer patients without insurance to public hospitals. But a new study from Stanford University has turned dumping on its head. It finds that hospitals are less likely to transfer critically injured patients to trauma centers if they have health insurance.

Arkansas' compromise to renew its Medicaid expansion plan was rejected by the state House of Representatives in a 70-27 vote. With nearly 90,000 low-come individuals enrolled in the plan, failure to re-launch the program raises questions about its future in the state.

Conservative Republican state officials who oppose the federal health care overhaul told Kansas legislators Tuesday that they can position the state to opt out of its requirements.

Colorado is one of eleven states that are starting to make a lot of health care prices public.