CMS Bundles: Why Leave Millions on the Table?
Health systems will soon learn how successful their participation in the mandatory Comprehensive Care for Joint Replacement program has been.
Readmission Rates: Not a Sound Quality Reporting Indicator
Rose Rohloff describes how healthcare organizations must track the right data to determine whether reduced readmissions truly mean an increase in quality.
No Easy Choices: What Lies Ahead for Healthcare Reform
Authors of the bill to replace the Affordable Care Act face a complex challenge in attempting to make high-quality care available to a large population at affordable rates.
Optimizing the Preauthorization Process
Senior healthcare provider and health plan leaders examine the difficulties associated with preauthorization and offer strategies for how stakeholders can collaborate to optimize the process.
The Future of Value
The move toward value remains a constant although the future of health care is uncertain.
Contemplating the Potential Impact of the AHCA
Understanding legislation proposed to repeal and replace the Affordable Care Act (ACA) is important, given that a bill to repeal and replace the ACA seems inevitable.
Maximizing Out-of-Network Payment for Patients with ACA Exchange Products
Hospitals should take steps to ensure the receive the full payment to which they are entitled for out-of-network patients enrolled in health plans purchased on the Affordable Care Act insurance exchange.
Four Strategies to Maximize Adult Immunization Quality and Financial Benefits
Jill Powelson describes how healthcare organizations can maximize revenue opportunities for immunizations.
Value-Based Payment—from a Different Perspective
Giesinger Health System has gained many advantages from offering its own, provider-sponsored health plan.
Assessing the Impact of Medicaid Expansion
Medicaid expansion reduced the amount of hospital charity care in participating states, while charity care remained almost unchanged in non-participating states during the same time period.