Reimbursement

Providers Should Keep Watch on Payer Discount Increases

A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.

Jeanne M. Slates November 2, 2018

Nov. 5-9: Azar to Discuss Primary Care Amid Expectations of New Models

Nov. 1—Primary care will draw the attention of the Trump administration next week, amid the expectation that upcoming payment models will focus on that segment.

Rich Daly November 2, 2018

Physicians Want APM Changes to Slow—Contrary to Administration’s Plans

Oct. 30—Physicians across the country are concerned about rapid changes in alternative payment models (APMs) and want the process to slow down, according to a recent study. Meanwhile, Trump administration officials say physicians should prepare for accelerated changes.

Rich Daly October 31, 2018

Value-Focused Healthcare Strategy Must Be Multifaceted

Moving to a value-based payment model involves change and requires a strategy focused on both managing costs and enabling growth of the enterprise.

Theresa Hush October 29, 2018

Why Your Access Strategy Demands Pricing Transparency

Consumers have come to expect price transparency in health care, which has greatly increased the strategic and operational importance of providers’ charge master descriptions and other pricing frameworks.

Nicholas Malenka, MHA October 29, 2018

The 2019 ACA Enrollment Period Begins

Rising premiums and reduced choice among insurance options are two challenges facing health insurance purchasers under the Affordable Care Act in 2019; nonetheless, public support for the act continues to be strong enough to block efforts to repeal the act.

Gail R Wilensky, PhD October 29, 2018

Hospital Advocates Concerned About Trump Drug Price Plan

Oct. 26—Hospitals would face uncertain financial impacts under a Medicare drug payment pilot announced this week.

Rich Daly October 29, 2018

Reconciling Charges and Pricing Through Charge Description Master Redesign

Providers should restructure pricing schedules to bring charges into better alignment with the actual cost of services, developing a long-term pricing model that is attractive to both patients and employers.

Leonard Brauner, CPA October 26, 2018

Oct. 28-Nov. 2: As Open Enrollment Looms, Individual-Market Changes Coming

Oct. 25—Next week’s start of open enrollment for the individual health insurance marketplaces comes as the Trump administration moves forward with an overhaul.

Rich Daly October 26, 2018

Taking on Risk? Top Ways to Leverage Strategic Partnerships for Integrated Care

Jim Wieland discusses the steps a practice took, and the lessons it learned, as it formed the nation’s first cardiology accountable care organization.

Jim Wieland October 25, 2018
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