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.
How hospital quality executives are pitching value-based payment to CFOs
Healthcare quality-improvement executives see ways in which an emphasis on value can improve some hospitals’ finances.
Healthcare reform moves to the states: Strategies to increase access and control costs
An increasing number of states are looking to improve access and reduce costs by funneling innovations, such as a public option or reinsurance program, through Medicaid.
Legislative fight over surprise billing is nearing an end, congressional aide says
Congressional negotiators are said to be close to a compromise on legislation that aims to end surprise medical bills.