Risk-based contracting in the time of coronavirus
The APM target prices/benchmarks are among the many policy issues beyond paying for surge capacity that CMS, commercial health plans and providers will need to work through in the wake of the coronavirus outbreak.
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.
Prior-authorization cost and time burdens increase for providers, report finds
Provider burdens from health plans’ use of prior authorization continue to mount amid calls to make the process fully automated.
Atrius Health: Experience with global-risk contracts paves way to success in new arrangement
Previous success in risk-based contracts will allow Atrius Health to thrive in its new global-risk arrangement with Blue Cross Blue Shield of Massachusetts, two of the provider’s leaders write.
Auth-DP software helps streamline prior authorizations to reduce denials
A leading revenue cycle technology company talks about how its innovative prior authorization software streamlines the process of checking for, obtaining and following up on prior authorizations, saving organizations millions in avoided denials.
A closer look at healthcare payment methods
A short description of payment methodologies offers context on the argument about whether fixed fees are preferable to percent-of-charge provisions.
Why removing percent-of-charge provisions in managed care contracts won’t address concerns about high hospital charges
Removing percent-of-charge provisions in favor of fixed fees would not remove the factors that drive price increases, nor would it reduce administrative hassles or decrease risk.
Analysis: FY20 appropriations bills passed – lessons for potential future healthcare legislation
A review of the FY20 appropriations package to fund the federal government and a couple of ideas on lessons that might be applied to future efforts to expand coverage.
‘Medicare for All’: What would it really mean for healthcare stakeholders?
“Medicare for All” would have varying impacts on hospitals, physicians and health plans but would be expected to cause financial hardship in the majority of cases.
‘We were completely wrong’: How Henry Ford Health System won a major direct contract
How one health system won a large direct contract as such arrangements become more widespread.