Aug. 27-31: Individual Market Rates Roll in Amid Tweaks
Aug. 23—States are scrambling to implement last-minute supports for the individual-insurance markets, even as 2019 rates begin to be finalized.
Even Successful Medicare ACOs Lose Money: Analysis
Aug. 22—Accountable care organizations (ACOs) that succeeded in earning bonuses from Medicare garnered less revenue than they would have under the fee-for-service (FFS) payment system, a recent analysis found.
Understanding Pricing Trends in a Changing Environment
Pricing data can help providers make more informed strategic decisions and build better relationships with their patients.
A Push to Streamline Value-Based Payment
Value-based payment is ripe to repeat past fee-for-service problems—widespread slowdowns as each entity took different approaches to data collection and sharing and, as a result, hampering interactions. CAQH CORE is getting in front of these challenges now.
How to Get Involved in CAQH CORE’s Work
CAQH CORE currently is forming groups to work on healthcare data standardization. Healthcare finance professionals are a core constituent and CAQH welcomes their participation.
ACO Advocates Warn on Program Overhaul
Aug. 13—A proposed overhaul of Medicare’s primary accountable care organization (ACO) program could cause massive departures, advocates for the entities warned soon after it was issued.
Why Fee-For-Service Remains Prominent
Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.
Bundled Payment Deals Prompt Hospitals to Rethink Relationships with SNFs
Aug. 14—Hospital and health system CFOs who are trying to make bundled payments work may find an answer in closer clinical alignment with skilled nursing facilities (SNFs), according to a new study.
How to Really Know Your Payment Rates
A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.
Hospitals Are Using Cost Reduction to Trim Patient Charges
The healthcare industry has undergone a major decrease in average annual charge growth. Hospitals at the lowest end of the charge growth spectrum are using cost reduction to slow the level of charge change.