As the healthcare industry especially the medical insurance space continues to seek methods for reducing ever-increasing costs, the bundled payment model shows more promise for payers and providers...
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...
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...
Chronic disease continues to lead to heavy healthcare spending and health payers have aimed their sights on better understanding methods for preventing and addressing chronic medical conditions. Both...
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...
On January 15, 2016, the final rule for the Comprehensive Care for Joint Replacement model took effect, which is a new reimbursement program for orthopedic surgeries developed by the Centers for...
The Center for American Progress released a report last Spring that tracks the progress and success of alternative payment models within the Medicare program. The report outlines that a...
Earlier this week, the Department of Health and Human Services (HHS) announced new funds available of as much as $157 million to develop an Accountable Health Communities Model, which will show whether...
Accountable Care Organizations (ACOs) were established in order to strengthen care coordination among a multitude of medical facilities, improve population health management, and stabilize rising...
While bundled payment systems have been advocated as a means to reduce the costs of medical care by the Centers for Medicare & Medicaid Services (CMS), many health insurers and providers are still...
On October 1, 2015, healthcare providers and payers across the entire nation switched over to ICD-10 diagnosis coding and left the ICD-9 coding behind. Today the ICD-10 diagnosis coding system is being...
Earlier this year, the federal government passed the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), which reforms the Medicare program by abolishing the Sustainable Growth Rate (SGR)...
The healthcare payer industry is expected to change drastically over the coming years as more insurance companies adopt new business models and focus on value-based care. Moving away from...
In HealthEdge’s State of the Payer Industry Survey, more than 80 percent of polled health payers are planning to support value-based payment models over the next three years. Additionally, nearly...
In recent months, four major players in the health insurance market have come together to form two separate mergers. The Aetna-Humana and Anthem-Cigna mergers have caused significant uproar among...
When healthcare providers join together to form an Accountable Care Organization, a major goal of theirs is to improve the health of their given population. But what are some key areas where ACOs and...
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...
In 2014, the rise of prescription drug spending hit 13 percent while overall healthcare spending growth increased by 5 percent. This steep rise is causing concern among both federal agencies like the...
Population health management is a complex area within the healthcare industry that has received a much bigger spotlight in recent years. In particular, after the Patient Protection and Affordable Care...
Ever since new legislation such as the Affordable Care Act or the Health Information Technology for Economic and Clinical Health (HITECH) Act were passed, the healthcare industry has been reforming and...
