Revenue Cycle Management

Price Transparency May Lower $27 Billion in Healthcare

by Vera Gruessner

Price transparency in the healthcare industry is becoming more and more pertinent and sought after. Research has shown that there is still insufficient price transparency within the medical field...

How Health IT Automation Improves Consumer Satisfaction

by Vera Gruessner

New technologies and health IT tools are becoming a necessary part of the health insurance industry, as innovative approaches like automation can largely benefit employees while portals could make a...

Is Health Information Technology ‘Imperative for Payers’?

by Vera Gruessner

Health information technology remains a key aspect of maneuvering the health payer industry toward automating workflows and improving medical claims management. However, some insurers are still having...

Will Health Insurance Mergers Stifle Market Competition?

by Vera Gruessner

Health insurance mergers and acquisitions have been a major topic within the payer industry lately. While companies that have pushed through with their mergers cite their potential cut of competition...

Healthcare Payment Reform May Need the Employer Perspective

by Vera Gruessner

At the Healthcare Financial Management Association (HFMA) National Payment Innovation Summit taking place February 10 to 12 in Memphis, Tennessee, a multitude of stakeholders gathered to share ideas...

Precision Medicine is a ‘Whole New Ballgame for Insurers’

by Vera Gruessner

Recently, President Barack Obama has announced a national “Moonshot” program to put an end to cancer as a whole. Vice President Joe Biden has been appointed the main leader of this project,...

Cost Transparency, ‘Consumer-driven Healthcare’ Impacts Payers

by Vera Gruessner

Cost transparency remains a vital aspect of healthcare reform among both providers and payers. Uninsured consumers and those who have employer-sponsored health coverage are continually finding the...

Why Payers Need Robust Health Information Technology

by Vera Gruessner

Health information technology continues to be an elusive field for the payer industry, as some insurers still have difficulty with adhering to key technological advancements and data security...

AHA Claims Stark Law Harms Value-based Care Reimbursement

by Vera Gruessner

The American Hospital Association (AHA) has encouraged Congress, specifically the House Committee on Ways and Means, to put an end to regulatory obstacles standing in the way of value-based care...

Payers, Providers Use Population Health Management to Cut Costs

by Vera Gruessner

Health payers and providers of today are working more closely together to develop effective care management strategies meant to reduce medical costs, improve quality of care, and ensure better patient...

How ACO Providers Could Integrate Specialty Care with PCPs

by Vera Gruessner

Healthcare providers and payers working together to develop an effective accountable care organization (ACO) and a strong contract will need to consider the importance of including specialty care, an...

HIV/AIDS Patients Struggle with High Healthcare Costs

by Vera Gruessner

The high costs within the healthcare industry are often associated with managing the health of patients living with chronic medical conditions. At the J.P. Morgan’s Healthcare Conference in early...

How Paid Sick Leave Could Reduce Patients’ Financial Burden

by Vera Gruessner

One of the most looming issues within the healthcare industry has been the medical debt that many citizens around the nation incur if they are struck with a serious acute or chronic illness. A report...

Key Steps toward Affordable Health Insurance Platforms

by Vera Gruessner

The average insured consumer is facing a whole new landscape when it comes to managing the costs of care. The prices surrounding health insurance plans and coverage options are rising steadily while...

CMS, AMA Delve into Past and Future of Healthcare Market

by Vera Gruessner

Yesterday, representatives from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association came together to provide an overview of the current healthcare market in a...

Health Payer Tips for Negotiating Managed Care Contracts

by Vera Gruessner

With the medical industry focused on population health and the need to stabilize rising costs, it is no wonder that more healthcare providers and payers are negotiating managed care contracts. When...

Drug Spending Dashboard Shows Lack of CMS Negotiating Power

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the release of an online dashboard that reports the amount of funds Medicare spends on prescription drugs. The drug spending...

How Care Management Strategies Could Reduce Medical Costs

by Vera Gruessner

When it comes to managing the treatment and financial implications of complex medical conditions, health payers and providers will need to work together and have effective cross-industry communication....

How Total Cost of Care Transparency Aids Payment Reform

by Vera Gruessner

What’s the first step in addressing methods for reducing medical costs and strengthening healthcare delivery? Improving transparency behind healthcare spending as well as educating stakeholders...

How Physician Home Care Lowers ER Visits and Healthcare Costs

by Vera Gruessner

A common healthcare service provided to many patients with chronic medical conditions is the typical checkup from a visiting home nurse. One medical company called Heal is giving patients a step up...