In recent years, healthcare reforms have set out to reduce constantly rising medical costs, improve coverage for the many Americans who lacked primary care access, and advance population health outcomes. Over the past few years, the...
The future for the health insurance industry likely revolves around value-based care payment, which has grown in use steadily over the last several years. Recent healthcare reforms have centered around...
The healthcare industry’s fast pace transition to value-based care reimbursement has led to some major challenges for both providers and payers. Adopting completely new payment contracts...
While healthcare regulations like MACRA legislation often centers around impacting medical providers, the health insurance industry is also integrated into the tapestry of value-based care and...
High-deductible health plans are becoming more and more common across the health insurance industry. With the many changes that the Affordable Care Act (ACA) has brought, payers are attempting to...
While downside risk does not incentivize providers to take part in value-based care reimbursement policies, data-driven technology and a combination of financial motivations may encourage physicians to...
When payers begin to adopt bundled payment models, they may find some challenges standing in their way to truly succeed within these alternative payment solutions. For example, when attempting to...
MACRA regulations may seem overly complex and lengthy for the average medical practice but there are steps that providers can follow to succeed under MACRA’s quality payment program. Providers...
MACRA legislation may play a major part in advancing the adoption of value-based care reimbursement among both payers and providers. CMS Acting Administrator Andy Slavitt emphasized this past May that...
Since some private health payers are struggling with enrollment and the ability to make a profit on the health insurance exchanges, engaging consumers, reducing the administrative burden, and creating...
The coming years will further position the medical industry including payers to adopt value-based care reimbursement models and new healthcare delivery systems partially due to the reforms that came...
Before the Patient Protection and Affordable Care Act (ACA) became law on March 23, 2010, the healthcare industry faced a number of obstacles particularly in terms of providing medical care and health insurance to many low-income families...
The transition to value-based care payment from fee-for-service payment methodology has come about due to the constant rise of healthcare spending. In fee-for-service, healthcare providers are...
In March 2016, the Department of Health & Human Services (HHS) proposed the expansion of Medicare coverage for the Diabetes Prevention Program. The funding for this program comes from the...
Health insurance companies, employers, and the workforce take a number of different steps to ensure that the best decisions are made in terms of health plan policies and covered benefits. For a variety...
Earlier this month, the Department of Health & Human Services (HHS) announced the release of the finalized ruling for the MACRA legislation. Along with gutting the flawed Sustainable Growth Rate...
The Centers for Medicare & Medicaid Services (CMS) have heavily invested in pursuing bundled payment models as an alternative form of payment for medical care among Medicare beneficiaries....
Health insurance companies are still struggling with improving price transparency in order to gain greater trust from their consumer base. One survey has shown low customer service satisfaction and a...
Commercial payers are following the lead of the Centers for Medicare & Medicaid Services (CMS) when it comes to adopting value-based care payment protocols. More private payers have implemented...
In 2015, the national insurer Anthem began proceedings to acquire Cigna while Aetna planned to merge with Humana. Very quickly, opposition lined up against the two planned health insurance mergers,...