Proposed MA Change Positive for Plans: Analysts
Jan. 3—Proposed policy changes that were recently released for Medicare Advantage (MA) plans—coupled with expected rate increases—should boost those insurers, industry analysts say.
Forum Networking Webinar: Managing Third-Party Liability Claims: A Boston Medical Center Case Study
A Boston Medical Center patient financial services director shares strategies for managing third-party liability claims.
Emerging Value-Based Payment Trends Transforming Health Care in 2018
Hospitals and health systems plan a range of care delivery innovations in 2018 to help them reach more of the quality improvement goals of various payment models.
Trend Toward Increasing Payer Deductions Continues
Payer deductions continue to increase, with government payers far exceeding private and managed care plans.
Ask the Experts: Payer Preference for Imaging Centers
Our hospital is beginning to feel the sting of payers steering their members from scheduled high-end imaging procedures at our facility to free-standing imaging centers. How are other hospitals and health systems responding to or reacting to this practice?
United HealthCare ACO Contract Emphasizes Quality
The NexusACO health plan incentivizes patients to use top-performing physicians.
Targeted Care Integration Can Help Drive Success Under Risk Contracts
Providers can avoid many of the missed opportunities associated with risk contracts by carefully reviewing the targeted patient population, narrowing the number of performance metrics, and selecting the right clinicians to participate.
6 Practices for Effective Managed Care Contracting
Certain practices are critical to effective contracts between health plans and provider organizations.
Value-Based Payment and Commercial Healthcare Insurers: Getting Paid for Doing What’s Right
Healthcare providers may find that their managed care contracts include provisions that may have been beneficial under a fee-for-service payment model but are highly unfavorable under a value-based payment.
Ask the Experts: Managed Care Contracting Benchmarks
Do you know of other avenues besides our state Department of Insurance that we can pursue to resolve health plan payment issues?