Social determinants of health ROI challenges are not yet outweighing potential benefits to patients
The continued shift to value-based care ensures health providers will continue to address SDOH factors.
Quality is table stakes, but patient financial experience of care is key to future referrals
A high-quality patient financial experience of care is key to a steady stream of referrals.
Not like the others: House Ways and Means surprise bill legislation
Provider friendly House Ways and Means surprise bill draft legislation doesn't rely on a benchmark payment rate like competing versions.
Humana partners with private equity firm to expand its primary care capabilities
Humana employing primary care physicians will help improve financial results for its plans by increasing HCC and Stars scores (increased revenue) and reduce medical expenses by improving care management and using claims data to make referrals to lower-cost providers.
Is Walmart taking a page out of Clayton Christensen’s playbook?
Walmart developing a low-cost service focused on a segment of the market that traditional players tend to avoid – the uninsured and underinsured – may signal ambitions to move further into healthcare delivery.
HFMA provides comments in support of its members on ‘tri-agency’ price transparency proposed rule
HFMA comments on and suggests improvements to a proposed rule issued by U.S. Departments of Health and Human Services, Labor and the Treasury requiring health plans to provide their members with out-of-pocket cost estimates.
With millions of physician referrals up for grabs, partnerships with consumer-centric sites of service matter
HFMA’s Chad Mulvany says in today’s competitive environment where traditional referral patterns are at risk of being upended, it’s crucial for health systems to partner with disruptors like CVS to capture these downstream opportunities.
Mid-Ohio ‘Farmacy’ principals encountered several surprising challenges trying to combat food insecurity
The Mid-Ohio “Farmacy” effort echoes what HFMA heard from participants at its recent Thought Leadership Retreat about tackling social determinants of health and highlights the complexities in the healthcare system for establishing such partnerships.
Rising out-of-pocket cost of having a baby can impact hospital revenue and reputation
The increase in consumer out-of-pocket costs for having a baby can have a negative impact on both a hospital’s financial performance and its perception in the community.
Analysis: Advanced analytics company partners with Emory Healthcare
If healthcare providers are going to be successful in lowering the cost of healthcare, they may need to find a partner that can crunch the data to help them understand their cost to deliver care at the case/patient level.