Sidebar: Top 10 Most Under-Documented HCCs
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
CMS Proposal: A Path to an Uncertain Future for 340B
CMS’s proposal to reduce rates for 340B-covered entities for separately payable outpatient drugs may indicate the Trump administration may take an aggressive approach to healthcare policy.
6 Practices for Effective Managed Care Contracting
Certain practices are critical to effective contracts between health plans and provider organizations.
the role of HCCs in a value-based payment system
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
Charging Appropriately for Emergency Department Visits
To determine a fair charge for an emergency department visit, a hospital or health system must separate its costs into three categories.
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.
Optimizing Financial Performance Under Value-Based Care
As they seek to adapt their organizations to the demands of value-based care, physician leaders can follow the example of participants in the Oncology Care Model.
Optimizing Financial Performance Under Value-Based Care
As they seek to adapt their organizations to the demands of value-based care, physician leaders can follow the example of participants in the Oncology Care Model.
Setting Competitive Prices with the Consumer in Mind
Finance leaders face a difficult balancing act when setting prices, particularly for new services.
Highmark Sees the ‘Value’ in VBID for MA Plans
Ellen Galardy of Highmark, Inc. describes the health plan's participation in a value-based insurance design pilot that seeks to improve the care of chronic conditions.