Reimbursements

Providers pleased at most of what's in new voluntary bundled payment model January 29, 2018 | Susan Morse - Associate Editor, Healthcare Finance
BPCI 2.0 is further evidence that CMS is continuing down the road road to value, triggering provider confidence and commercial payer interest.
Community health center funding cliff could cause more than 100,000 job losses December 12, 2017 | Jeff Lagasse - Healthcare Finance Associate Editor
Centers' ability to provide care to underserved patients will be seriously compromised if the $3.6 billion cut in funding isn't immediately restored.
Healthcare spending growth slowed in 2016 December 12, 2017 | Susan Morse - Associate Editor, Healthcare Finance
Private health insurance continues to be the largest payer for healthcare goods and services, accounting for just over one-third of total spending.
OnBase unveils new platform for increased transparency for payers September 11, 2017 | Mike Miliard - Contributing Editor
Mackinac enables easier collaboration, expedited document sharing between providers and payers, Hyland says.
CSR uncertainty could cause 9.4M uninsured, 37% premium increase, report says September 11, 2017 | Susan Morse - Associate Editor, Healthcare Finance
Insurers must decide whether to assume CSRs will continue, increase premiums, or leave market.
Insurers plan sharp rate hikes next year unless Congress removes uncertainty by appropriating money to pay discounts, about $10 billion in 2018.
4 former national coordinators, a CIO and a CEO weigh in on how to fix meaningful use September 11, 2017 | Tom Sullivan - Executive Editor, HIMSS Media
A rock star lineup of health IT pros including Karen DeSalvo, John Halamka weigh in on where the program went astray and suggest the direction that government and industry should steer towards.
CHIP reauthorization complicated with packed legislative calendar this month September 11, 2017 | Phil Galewitz, Kaiser Health News
A Kaiser Family Foundation survey this summer of state Medicaid officials said 10 states would run out of CHIP funding by end of the year.
NQF says interoperability goes far beyond EHR-to-EHR data exchange September 05, 2017 | Tom Sullivan - Executive Editor, HIMSS Media
The National Quality Forum has released new guiding principles for a truly interoperable healthcare system.
Only 3.3% of emergency room visits are 'avoidable,' study says September 05, 2017 | Susan Morse - Associate Editor, Healthcare Finance
Most patients who are in the emergency department belong there and insurers should cover those visits, ACEP says.
Employers are seeking bundled payment assistance with help from a start-up that makes suggestions about surgery options based on analyzed data.
MGMA: Medical practices focused on customer service, revenue cycle training August 28, 2017 | Beth Jones Sanborn - Managing Editor of Healthcare Finance News
Last year's poll saw MACRA being top of mind, but flexibility with that policy has eased their worry.
Canopy Health to add UnitedHealthcare to unique provider-payer network in California August 28, 2017 | Susan Morse - Associate Editor, Healthcare Finance
The health system pays the claims, accepts the risk of a health insurer, but does not sell coverage directly to consumers.
New bundled payment models will switch power from hospitals to physicians, Altarum says August 22, 2017 | Susan Morse - Associate Editor, Healthcare Finance
Expect CMS to release more voluntary bundled programs by the end of the year that focus on outpatient payments, expert says.
'Mixed' results from payment reform efforts should steer future course, not condemn them entirely, Health Affairs says August 22, 2017 | Beth Jones Sanborn - Managing Editor of Healthcare Finance News
Initiatives attempted "wholesale practice transformation," which yielded little financial gain or improvements in quality, authors wrote.
Litigation underway in fee-for-service vs. managed care coverage in California August 14, 2017 | Emily Bazar, Kaiser Health News
The lawsuit alleges the state illegally reversed doctor and court decisions for patient to remain in fee-for-service Medi-Cal.
Small practices plagued by complexity of Medicare regulations, show dim view of MIPS, MGMA study shows August 14, 2017 | Beth Jones Sanborn - Managing Editor of Healthcare Finance News
Survey evaluated responses from 750 group practices, with largest representation from independent practices, groups of 6 to 20 physicians.
Medicaid's budget bursting over climbing prices of older drugs August 14, 2017 | Sydney Lupkin, Kaiser Health News
Rising costs for 313 brand-name drugs lifted Medicaid's spending by as much as $3.2 billion in 2016.
Texas doctor slapped with 35-year sentence and $268M in restitution for massive fraud scheme August 14, 2017 | Beth Jones Sanborn - Managing Editor of Healthcare Finance News
The Department of Justice said the elaborate fraud scheme "takes brazen to a whole new level."
The Every Prescription Conveyed Securely Act, filed in the U.S. House of Representatives, would mandate e-prescribing for controlled substances under Medicare Part D.

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