Reimbursement

A real-time location system (RTLS) provide critical access hospitals with an effective means for accurately tracking physician availability time for delivering emergency department services, thereby potentially increasing Medicare payments.

Henry Ford Health System expects to succeed in its direct-contracting initiative with General Motors, thanks in large part to its capabilities in areas such as analytics, case management, and patient engagement.

Ken Perez comments on the need for both parties in Congress to set aside partisan differences and find common ground in passing bipartisan legislation to solve key problems affecting the nation’s healthcare system.

Jan. 17—As Congress’s primary Medicaid advisory body prepares to meet next week, hospitals and insurers are clashing over changes to the program’s managed care rules.

Clinic visits in hospital settings and 340B payments are among the changes to be aware of in 2019.

The University of Maryland St. Joseph Medical Center model layers a 50/50 share of any incentive payments on top of a work RVU-based component to account for revenue that is still generated by the number of patients that providers see. 

Jan. 14—Medicare’s first mandatory bundled payment program succeeded in obtaining some savings in its first two years, according to new research.

BlueCross BlueShield of Western New York has removed prior authorization requirements for more than 500 therapies, services, and procedures in conjunction with its move to value-based payments for primary care providers.

Chris Williams explains how to craft stop-loss contracts for employee health plans.

Jan. 8—Despite concerns that savings and quality improvements are elusive in bundled payment episodes for chronic medical conditions, one of the largest health systems aims to expand its use of such payment models.