By Susan Bellile – As we kick off 2022, one of the big questions surrounding interoperability is the status of the payer-to-payer data exchange rule. The requirement was part of the May 2020 Final Rule supporting the 21st Century Cures Act, and its enforcement was scheduled to start on January 1. However, in September CMS delayed enforcement pending future rulemaking.
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By Dr. Richard Watson – No surprise to state that money drives the motivations and decision-making in healthcare. It is certainly noted that the rank-and-file patient care cohort continues to carry the quality torch, but even these voices are filtered through a complex algorithm of “metrics” and “standards.”
By Scott Overholt – Payer-required administrative tasks are a burden most providers know all too well. They are a daily source of frustration, diverting time from mission-critical work and often delaying patient care. Legislation impacting audit and authorization processes is in constant flux, only increasing confusion about payer requirements and regulations.
By Teresa Younkin – As we start rolling up our sleeves to get to work in 2022, we already are seeing several trends that will continue to transform healthcare in the year ahead. Payers will have their work cut out for them and will be forced to adapt, with many modifications coming sooner than later.
By Mark Menton – The sometimes adversarial relationship between providers and health plans is well documented – and its patients who end up in the crosshairs of the fragmented healthcare system. Amid government mandates, evolving customer demands, and rapid-fire innovation, many providers and plans realize they can’t go it alone anymore.
Latest news being reported on payers and the health insurance industry including news from KindHealth, Cigna, UnitedHealthcare, Oscar Health, Blue Cross Blue Shield Association, Humana, AHIP and more.
By David Burda – One of my favorite scenes in The Princess Bride is when Miracle Max tells Inigo and Fezzik that Westley is “mostly dead,” which means he’s “slightly alive.” There’s hope for a full recovery. We can say the same thing about value-based reimbursement, if we have as much faith in a few recent VBR status reports as Inigo and Fezzik have in Miracle Max.
Latest news being reported on payers and the health insurance industry including news from UnitedHealthcare, CVS Health, Blue Cross Blue Shield Association, Humana, UnitedHealth Group, Medica, Cigna, Oscar Health, Independence Health Group, and more.
Latest news being reported on payers and the health insurance industry including news from AHIP, Anthem, Blue Cross and Blue Shield, CareSource, Cigna, CVS Health, Humana, UnitedHealthcare and more.