By Dr. Martin Lustick – In April, NextGen Healthcare’s leadership team met with leaders of provider organizations representing a range of specialties and geographies. One of the themes that came through loud and clear was their ongoing struggle to obtain claims data from their payers.Read More
Healthcare Revenue Cycle and Finance
By David Burda – Hospitals, health systems and medical practices are businesses just like businesses in any other industry. They respond to economic incentives, and they do things for economic reasons. Plain and simple. Well, maybe not so plain and simple.
National Association of ACOs President and CEO Clif Gaus, Sc.D., issued the following statement today on the Centers for Medicare & Medicaid Services’ Proposed 2023 Medicare Physician Fee Schedule:
Latest news being reported on payers and the health insurance industry including news from Oscar Health, Aetna, AHIP, Very Well Health, UnitedHealth Group, Humana, Cigna, Oscar Health, HPI, Employers Health Network and more.
By Diana Bauza – The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model is a pilot program designed to replace the current Global and Professional Direct Contracting (GPDC) Model. A model to promote greater health equity among the ACO beneficiaries.
Latest news being reported on payers and the health insurance industry including news from 1upHealth, NCQA, AHIP, CVS Health, Independence Blue Cross, Anthem, CVS Health, Blue Cross Blue Shield Association, UnitedHealthcare, and more.
AMA survey shows, health insurer industry continues to show apathetic or ineffectual follow-through on mutually accepted reforms despite mounting evidence that insurer-imposed authorizations for drugs and medical services can be a hazardous and burdensome administrative obstacle to patients.
By David Burda – By now, we all know that hospitals’ level of compliance with the new price transparency rule would not be described as robust. It’s whatever the opposite of robust is. Feeble? Pathetic? Weak? There’s been a lot of speculation as to why even at this point, nearly 18 months after the rule went into effect.
By Lisa Miller – Physician preference items or physician driven spend is a significant driver for hospitals. Hospitals should aim to work together with their physicians, not just work with them when the need arises. Three obstacles are observed when hospitals begin the initiative of engaging their physicians for cost savings.