Health Plan Payment and Reimbursement

Congressional hearing showcases the divergence in the two parties’ views on how to improve U.S. healthcare

One witness at a hearing of a House subcommittee touted price transparency as an essential tool for addressing healthcare costs.

Nick Hut March 27, 2021

Site-neutral payments could reduce healthcare spending by at least $350 billion over 10 years, report finds

If site-neutral payments were implemented throughout healthcare, the reduction in expenditures could total as much as $672 billion over a decade, according to a new report.

Nick Hut March 22, 2021

What healthcare stakeholders should know about the new COVID-19 relief legislation

New COVID-19 relief legislation includes funding for rural hospitals, provisions to increase the affordability of health insurance and more items of note for healthcare providers.

Nick Hut March 19, 2021

Providers that administer the COVID-19 vaccine are getting a payment bump from CMS

Providers will receive an increase in the Medicare payment rate for administering the COVID-19 vaccine starting March 15, CMS announced.

Nick Hut March 15, 2021

How a health system prepared to comply with CMS’s new price transparency rule

The efforts of one health system to meet state and federal price transparency regulations shows the benefit of integrating transparency efforts into a broader organizational strategy.

Elizabeth Barker March 12, 2021

New federal guidance seeks to clarify reimbursement of COVID-19 testing and vaccinations

Federal agencies have issued new guidance intended to make it easier for healthcare providers to receive reimbursement for administering COVID-19 tests to insured individuals and for giving vaccinations to the uninsured.

Nick Hut March 1, 2021

RAND report finds regulating hospital prices would be the most effective way to reduce healthcare spending, but are the proposals viable?

The American Hospital Association had a negative reaction to study findings showing that regulation of hospital prices would be the most effective way to reduce prices paid by commercial insurers.

Nick Hut February 21, 2021

Front-line stories: How today’s prior authorization processes create a burden of waste for providers

As hospitals continue to struggle with razor-thin margins, they should actively identify activities that create financial burdens for them without delivering value to patients. One health system’s stories of administrative waste due to prior authorization processes show why this activity should be be high on their list.

Alan S. Kaplan, MD, MMM, FACPE February 19, 2021

Report: Large sampling reveals 30% of hospitals haven’t complied with any aspect of the new price transparency requirements

Hospitals have had an easier time posting the required price information for consumer-friendly shoppable services than for all the services in their chargemaster, according to a large survey.

Nick Hut February 13, 2021

A look at some of the healthcare-specific provisions in the pending COVID-19 relief legislation

As a $1.9 trillion COVID-19 relief package makes its way through Congress, provisions under consideration could affect the Provider Relief Fund, the Affordable Care Act insurance marketplaces and Medicaid.

Nick Hut February 11, 2021
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