Health Plan Payment and Reimbursement

Hospitals express concerns on latest transparency order

A new transparency executive order will require proposed rules within two months that could require release of negotiated hospital health plan rates.

Rich Daly June 25, 2019

Analysis: New HELP draft surprise-bill legislation bases payments on geographic median rate

Recent changes to the HELP draft surprise-bill legislation indicate there is unity in Congress around calculating payments to providers for out-of-network services, but challenges to the geographic-median approach are on the horizon.

Chad Mulvany, FHFMA June 25, 2019

Little progress seen in mitigating prior-authorization challenges

Prior-authorization challenges appear to be worsening for providers, despite a 2018 payer-provider effort to address such problems.

Rich Daly June 23, 2019

What’s the blueprint for taking on risk?

Providers and health plans need to collaborate — both in the planning and execution of risk-based contracts — in order to make them work.

Rich Daly June 23, 2019

Opportunities and strategies for improving pharmacy financial performance

A roundtable of senior healthcare financial and pharmaceutical leaders that covers challenges and strategies for improving pharmacy financial performance.

HFMA June 18, 2019

Providers push arbitration approaches used in some state surprise-bill laws

What should Congress learn from states’ experiences with laws attempting to curtail surprise healthcare bills?

Rich Daly June 13, 2019

Timing, details unclear for executive order on price transparency

An expected executive order on healthcare price transparency continues to change, even as its release has been delayed, say policy watchers.

Rich Daly June 11, 2019

Arbitration approach the most likely option among pending surprise-bill legislation: analysts

Among numerous legislative approaches proposed to eliminate surprise healthcare bills, an approach using arbitration remains most popular in Congress, say legislative analysts.

Rich Daly May 30, 2019

Short-term plans have little adverse effect on insurance market: study

Although a federal boost to short-term insurance plans raised alarm among hospital advocates, early evidence suggests there has been little adverse impact on the individual insurance market.

Rich Daly May 20, 2019

New Healthcare Partnerships and Technology Bring Real Competition to Health Systems

Robert P. Chamberlain discusses the move toward employer-offered health care and how health systems can compete.

Robert P. Chamberlain February 1, 2019
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