Reimbursement

How narratives can drive hospital innovation

A healthcare start-up investor says established organizations can — and must — become innovators by using the power of narrative.

By Rich Daly June 26, 2019

Policy advisers urge continued Medicare ‘squeeze’ of hospital pay

Medicare can drive hospital productivity improvements and spending controls through more pay cuts, said policy advisers.

By Rich Daly June 25, 2019

Hospitals express concerns on latest transparency order

A new transparency executive order will require proposed rules within two months that could require release of negotiated hospital health plan rates.

By Rich Daly June 25, 2019

Analysis: New HELP draft surprise-bill legislation bases payments on geographic median rate

Recent changes to the HELP draft surprise-bill legislation indicate there is unity in Congress around calculating payments to providers for out-of-network services, but challenges to the geographic-median approach are on the horizon.

By Chad Mulvany, FHFMA June 25, 2019

ZDoggMD: How to get to healthcare 3.0

Motivational healthcare speaker urges changes to encourage and allow providers to engage emotionally with patients and drive real change.

By Rich Daly June 25, 2019

3 details for healthcare providers to know before taking on risk

Providers looking to take on downside ACO risk need to first understand three determinants of success.

By Rich Daly June 25, 2019

Forecast: ACA tug-of-war to continue through 2020

Given the political realities of a divided government, the forecast through 2020 calls for a continuation of the tug-of- war over the Affordable Care Act (ACA) in Washington. With the ongoing expansion of the field of Democratic Party contenders for the presidency in 2020, not to mention the continuing battle over the ACA between the…

By Ken Perez June 24, 2019

Little progress seen in mitigating prior-authorization challenges

Prior-authorization challenges appear to be worsening for providers, despite a 2018 payer-provider effort to address such problems.

By Rich Daly June 23, 2019

What’s the blueprint for taking on risk?

Providers and health plans need to collaborate — both in the planning and execution of risk-based contracts — in order to make them work.

By Rich Daly June 23, 2019

Providers press CMS for details amid lingering uncertainty about new primary care models

The possibility of conflicts between Medicare payment models joined the customary concern about benchmarking details in provider feedback on coming primary care models, an administration official said.

By Rich Daly June 20, 2019
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