Commercial health plans’ value-pay response to pandemic mixed, say providers
Commercial health plans have offered providers in value-based payments some pandemic-related flexibilities but rejected some changes.
Telehealth helped chronically ill during pandemic but their access to care worsened: CDC
Many chronically ill sought telehealth care during the pandemic, even as they reported worse care access, according to a CDC survey.
Looking beyond CMS: How to accelerate the transition to value in healthcare
HFMA's Chad Mulvany summarizes a blog on actions CMS and Congress can take to transition providers to capitated and other risk-bearing payment models.
Employers pivot from value-based payment to virtual care amid the pandemic
Employer-sponsored health plans are pausing value-pay expansions in favor of adding virtual care options in response to the COVID-19 pandemic, according to a business group survey..
Hospitals with health plans have gotten a financial boost during the pandemic
Hospitals with provider-sponsored health plans have obtained a financial cushion to offset the steep losses from the coronavirus pandemic on the provider side.
As the COVID-19 situation improves in Maryland, hospitals not immune to losses
Maryland hospitals suffered COVID-19 volume losses, but they say the state’s unique all-payer rate-setting system mitigated the situation to a degree.
Regional differences emerge in hospital volume recovery from COVID-19
Hospitals in the Mid-Atlantic have struggled the most to recover outpatient volumes as patient fears linger in the wake of the COVID-19 pandemic.
‘Carve outs’ among keys in managed care negotiations
Carve outs are a critical tool hospitals should use in negotiations with health plans to ensure the costs of more expensive conditions are covered.
Implement these 6 safeguards against fraud accusations in telehealth
Healthcare providers should take care to comply with payer policies around telehealth.
Hospitals scramble to meet price transparency requirements after court decision
Hospitals have a lot of costly work to do to meet CMS requirements to publicly post the rates they negotiate with health plans.