Hospital Reimbursement

How Employers Can Achieve a Fair Price in Hospital Negotiations

December 22, 2022 - Across the nation, Americans are feeling the pressure of escalating prices in nearly every area of life, from the grocery store to the clothing store to the gas pump. The hospital room is no exception. Hospital costs represent a significant portion of healthcare spending. Nearly a fifth of the average American’s premium dollar goes toward inpatient hospital services. Moreover,...

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Anthem, CA Providers Dispute Rates After Surprise Medical Bill Law

by Kelsey Waddill

California’s surprise medical billing laws are motivating Anthem to cut reimbursements to physicians in the state, providers argue. In June, California payer Anthem cut reimbursements for...

UHC Members May Face Surprise Billing at Boca Regional

by Kelsey Waddill

UnitedHealthcare and Boca Raton Regional Hospital missed their contract renewal deadline and are communicating to UHC members how to avoid surprise bills as the negotiations continue, the Sun Sentinel...

Hospital Payment Disparities Emerge Among Private Payers, Medicare

by Sara Heath

A new report from the RAND Corporation argues that private payers should rework their contracts with hospitals to align their payment rates with those seen in Medicare plans. The report, which looked...

Hospital Price Transparency Rule Takes Effect January 1, 2019

by Jennifer Bresnick

Starting January 1, 2019, hospitals will be required to post their price lists online in an effort to increase price transparency and empower consumers to make informed choices about their care. The...

Helping Payers Implement Value-Based Hospital Reimbursement

by Thomas Beaton

Hospitals generate some of the largest revenues and create exceptionally high costs for payers, which combine open the possibility for value-based hospital reimbursement programs to control...

MA Proposed Rule May Cut Savings from Ambulatory Surgery Centers

by Vera Gruessner

New proposed changes to current legislation from the Massachusetts Department of Public Health may either decrease the use of or potentially eliminate ambulatory surgery centers, according to a press...

Top 6 Factors for Success in Provider-Sponsored Health Plans

by Vera Gruessner

The health insurance industry may have a complete transformation on their hands with regard to hospital and medical practice reimbursement. The number of provider-sponsored health plans is growing...

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