The price of precision medicine: 3 ways for health plans to manage genetic-testing costs
With spending on genetic testing expected to grow significantly, health plans can use three steps to get a handle on costs.
A look at early hospital concerns over the proposed release of negotiated charges
National hospital advocates, individual executives and an industry adviser identified early concerns with the proposed mandatory release of hospital-negotiated charges.
OPPS rule to bring many hospital financial challenges — and a little help
The long-awaited Medicare proposed rule for hospital outpatient payments includes a high-profile mandate on hospitals to release rates negotiated with commercial health plans, among other regulations that could pose financial challenges. Several smaller provisions could help hospitals.
2 states take the lead in implementing innovative healthcare reforms
Washington and Colorado are seeking to funnel noteworthy innovations in healthcare reform, including a public option, through their Medicaid infrastructures.
Analysis: Survey results show health systems prepared to take risk
Results of a recent HFMA/Navigant survey show providers are prepared to increase their level of payment risk. HFMA’s Chad Mulvany provides insight on what these results indicate.
Pursuing a Proactive Denials Strategy Helps Resolve Denials and Prevent Recurrence
A look at how one company is partnering with healthcare organizations to use data and technology to address the root causes of long-standing problems, including denials.
Hospital executives urge colleagues to comment on upcoming transparency rules
Hospital and health leaders were urged by their colleagues to watch for and comment on coming rules implementing this week’s White House executive order on price transparency.
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.
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.
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.