Outpatient Care Providers

Hospital Outpatient Department Costs Consistently Outpace Offices, ASCs

September 20, 2023 - Given the significant difference between cost of care in hospital outpatient department settings compared to other settings for the same services, site-neutral payments could reduce healthcare spending, an analysis from Blue Cross Blue Shield Association (BCBSA) found. The researchers from Blue Health Intelligence, BCBSA’s data analytics and...

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Medicare Advantage Beneficiaries See Lower Hospitalization Rates

by Victoria Bailey

Medicare Advantage beneficiaries with ambulatory care sensitive conditions (ACSCs) experienced lower rates of hospitalizations but higher rates of emergency department (ED) direct discharges and...

Contracted Medicaid Managed Care Providers Treated Few Beneficiaries

by Victoria Bailey

Around one-third of primary care and specialty physicians that contracted with Medicaid managed care plans saw fewer than ten Medicaid beneficiaries over a year, suggesting that network adequacy...

VA Demonstrates How Health Plan Network Size Impacts Utilization

by Kelsey Waddill

When the Veterans Affairs department (VA) expanded its health plan network size, enrollee utilization and access to care improved, according to a study published in the JAMA...

How Ambulatory Surgery Centers Lower Payer Outpatient Spending

by Kelsey Waddill

Ambulatory surgery centers can be high value care sites for hospital outpatient services, according to UnitedHealth Group’s recent claims analysis. Ambulatory surgery centers are care sites that...

Individual Insurance Market Premiums Cover Widely-Used Services

by Kelsey Waddill

The individual health insurance market’s premiums mostly go towards highly utilized services, a Robert Wood Johnson study discovered. “The requirement that these essential benefits be...

CMS Announces Grants to Tackle Opioid Use Disorders

by Kelsey Waddill

CMS continues to wage war on the opioid epidemic with a new grant opportunity for plans to reduce opioid use disorders (OUD). “CMS is pulling every lever to combat the opioid epidemic, and...

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