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.
Is Focus of Value Based Care Moving From Hospitals to Physicians
Recent changes to bundled payment models are the among the developments that suggest the Trump administration may be seeking to shift the focus of value-based care from hospitals to physicians.