Why initiate health plan contract testing?
Various circumstances require providers to prepare for the impact of payment changes.
NFP hospital finances improve, Moody’s finds
Moody’s changed its outlook for not-for-profit hospitals from negative to neutral for 2020, citing improved revenue.
ACA tax drove 2018 healthcare spending acceleration, CMS actuaries find
National healthcare expenditures in 2018 increased slightly overall but declined as a share of the economy, according to a report from the CMS Office of the Actuary.
Upside-only pay surges as risk-based pay, clinical results remain flat, scorecard finds
Bonus-based value payment models have proliferated among employer health plans, while risk-based payment and performance on clinical quality indicators have not changed significantly, according to a recently published scorecard.
The price of innovation: 3 steps for managing specialty drug costs
Health plans can help control the cost of specialty drugs by communicating with providers about appropriate treatments, integrating coordination of pharmacy and medical benefits and implementing fixed-price models.
Congress is still expected to pass a surprise-bill measure this year
Congress is likely to enact surprise-bill legislation in the waning days of 2019, according to policy advisers.
One health system finds ‘millions’ of reasons to audit value-based payments
A health system identified millions of dollars in underpayments that it should have received as part of two value-based payment arrangements in recent years.
Administration finalizes requirement for hospitals to post rates paid by health plans
A newly finalized requirement will require hospitals to post rates that are privately negotiated with health plans, as well as rates for a list of 300 “shoppable services.”
Federal policy drives hospital-practice deals but not M&A between hospitals, MedPAC finds
Federal policy is not driving hospital M&A but is encouraging hospital purchases of practices, a key congressional advisory group said.
Transparency rule could come this month, White House executive says
A controversial requirement for hospitals to publicly post the rates they negotiate with health plans is expected this month, according to a senior White House official.