Payment Reimbursement and Managed Care

A White House plan to combat the omicron variant includes support for hospitals

The Biden administration announced several provisions to bolster hospitals as efforts to contain the COVID-19 pandemic enter a third calendar year.

Nick Hut December 22, 2021

How to create an employer-friendly healthcare center of excellence

Increasing health expenditures and the pressures of the recent pandemic have contributed to the development of a new type of center of excellence (COE), called the future-state COE, which is designed to better address the needs of large employers. This COE model incorporates value-based contracting and a strong incentive design into a service-line strategy to create employee health programs that benefit employers, patients and providers alike.

Kathy Najarian December 22, 2021

Key takeaways from HFMA’s latest Outlook Survey: Healthcare finance professionals anticipate technology-driven changes

HFMA’s most recent Outlook Survey of healthcare finance professionals highlights the potential of technology to usher in big changes in upcoming years.

Nick Hut December 22, 2021

Studies find glaring issues with federal price transparency requirements

The first year of federal price transparency regulations for hospitals hasn’t had high rates of compliance, nor has it consistently led to actionable information for consumers, according to two new studies.

Nick Hut December 21, 2021

2 new studies illustrate the burden of healthcare costs in the pandemic era

An annual report by CMS actuaries quantified the extent to which healthcare costs accelerated during the first year of the COVID-19 pandemic, while a separate survey looked at affordability.

Nick Hut December 20, 2021

Healthcare News of Note: A majority of physicians fear they missed signs of drug misuse during the pandemic and predict drug overdose deaths will rise, says a Quest Diagnostics report

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Physicians fear they missed signs of drug misuse during the pandemic, improved technology use is seen in patient engagement, and the majority of Medicaid health plans have a health equity plan.

Deborah Filipek December 17, 2021

Hospitals, physicians file lawsuit over the arbitration process in the new surprise billing regulations

Leading provider associations have asked a federal court to halt the incorporation of criteria that appear to favor insurers over providers in an arbitration process to determine out-of-network payment amounts.

Nick Hut December 10, 2021

A bill to mitigate scheduled Medicare payment cuts of $14 billion is ready to go in Congress

The House of Representatives is set to vote on a bill that would nullify a large share of 2022 Medicare payment cuts.

Nick Hut December 9, 2021

The economics of a telehealth visit: A time-based study at Penn Medicine

Research into the costs of delivering telehealth versus in-person visits by the Department of Orthopaedics at Penn Medicine sought to answer the health systems’ questions about the long-term economic viability of telemedicine services, and to help inform their conversations with payers about how much they should appropriately be paid for the services.

Neil Ravitz, MBA December 9, 2021

Hospital-at-home care promises to reshape healthcare delivery in the United States

Two leaders of health system hospital-at-home programs describe how the acute hospital care at home model represents an important change in how our nation approaches healthcare delivery, because it has been shown to yield improved care outcomes and greater patient satisfaction.

Eric C. Reese, PhD December 9, 2021
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