Today, the consumer or employee is left with much higher out-of-pocket costs than in previous years. Within the Kaiser Family Foundation’s 2015 Employer Health Benefits Survey, statistics show...
Health insurance is no longer primarily a business-to-business transaction between payer organizations and employers. Today, payers must be prepared to holistically meet the needs of millions of...
The expansion of value-based care reimbursement is making headway across US hospitals and clinics. To better prepare for the transition to value-based care reimbursement, IDC Health Insights, a...
While value-based care payments are making headway across the country, there are still barriers that stand in the way of payers and providers fully embracing these alternative payment models. A report...
Value-based care payments are quickly becoming a mainstay in today’s health insurance industry with more payers jumping on the bandwagon of bundles, alternative payment models, and accountable...
Episode-based bundled payments are becoming a sought-after reimbursement model throughout the healthcare industry. Along with the Centers for Medicare & Medicaid Services and its focus on...
Earlier this month, the mobile technology company athenahealth released its annual PayerView Report, which delves into the complex and evolving relationship between payers and providers, according to a...
Blue Cross Blue Shield of Arizona (BCBSAZ) has recently partnered with McKesson Business Performance Services to form a service-based organization called ACO Partner meant to function in the...
In order to ensure government funding isn’t used to pay erroneous or fraudulent medical claims, the Centers for Medicare & Medicaid Services (CMS) conducts risk adjustment data validation...
The proposed changes to the Medicare Part B prescription drug program is finding opposition among multiple medical organizations. The Centers for Medicare & Medicaid Services (CMS) will need to...
Value-based care reimbursement including bundled payment models or accountable care organizations may help medical providers and payers achieve the Triple Aim of Healthcare which is better patient...
The Patient Protection and Affordable Care Act led to the development of the Medicare and Medicaid Innovation Center, which eventually brought the creation of accountable care organizations...
Last week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that changes the Medicare reimbursement policies at skilled nursing facilities for 2017. Essentially, the...
The federal government has brought a tremendous amount of focus on reforming provider-payer reimbursement in order to reduce the rising healthcare expenditure around the country. New regulations have...
