Topics
Reimbursement
Cigna, Humana, other insurers waive costs for COVID-19 treatment
Cigna, Humana, others waive COVID-19 costs
Revenue Cycle Management
Managed care, revenue cycle performance strategies are critical to increasing payer yield
Managed care, rev cycle strategies can boost payer yield
Strategic Planning
Forecasting the future of HL7 FHIR at HIMSS20
Forecasting the future of FHIR
Capital Finance
Coronavirus is impacting the financial health of nonprofit hospitals, but CFOs have some options
How hospitals can mitigate the financial impact of coronavirus
Supply Chain
Horizon BCBS New Jersey gives $2.5 million for personal protection equipment
Horizon BCBS New Jersey gives $2.5 million for PPE
Accounting & Financial Management
Credit stress continues to rise in healthcare sector as maturities loom, social risks rise
Moody's: Credit stress is rising in healthcare
Budgeting
A dynamic healthcare budget process may trump traditional budgeting in terms of accuracy, flexibility
Benefits of a dynamic budgeting process
Quality and Safety
Survey confirms physicians lack tests and equipment to fight COVID-19
Physician survey confirms tests, supplies are lacking to fight COVID-19
Billing and Collections
For payers, patients and employees, coronavirus spending could exceed $20,000 for the most serious cases
COVID-19 spending could top $20K for payers, patients
Claims Processing
Humana is expediting claims processing and prior authorization during COVID-19 pandemic
Humana is expediting claims and prior authorization
Workforce
Some COVID-19 patients still have coronavirus after symptoms disappear, possibly endangering health workers
Some COVID-19 patients are still infectious after symptoms abate
Operations
Retrospective denials, prior authorization may be straining hospital and patient finances
Prior authorization may be straining hospital finances
Medical Devices
Apple is developing custom health information tracking chips
Apple is developing custom health chips
Hospital/physician relations
Quality of initial training makes a big difference in EHR satisfaction, KLAS report finds
Poor EHR training brings down provider satisfaction
Construction & Facilities Management
Kaiser Permanente cancels plans for $900 million headquarters in Oakland
Kaiser Permanente cancels $900M headquarters
Compliance & Legal
DOJ accuses Anthem of fraud in risk adjustment payments for its Medicare Advantage plans
DOJ accuses Anthem of fraud in risk adjustment for MA plans
Policy and Legislation
AHA wants federal stimulus funds to go directly to hospitals
AHA wants federal stimulus funds to go directly to hospitals
Community Benefit
Advocate Aurora Health contributed $2.1 billion to community charitable care and services in 2018
Advocate Aurora: $2.1B in charity care
Accountable Care
NAACOS urges CMMI to release more information on new payment model
NAACOS wants more information on new payment model
Acute Care
Critical care improvements may differ depending on a hospital's patient population
Patient population determines ICU improvements
Ambulatory Care
Medical schools, teaching hospitals account for 3% of US GDP, report shows
Med schools, teaching hospitals are 3% of GDP
Analytics
How analytics, SDOH insights are helping reduce ED use
How analytics, SDOH insights are helping reduce ED use
Business Intelligence
While the price of healthcare is growing, utilization is dropping and price variations persist, report says
HCCI: Price of healthcare is growing, utilization is dropping, price variations persist
ICD-10 & Coding
Physician practices examine risk adjustment coding in wake of federal lawsuits
Practices keeping close watch on risk adjustment coding
Meaningful Use
CMS overhauls meaningful use EHR program, renames it 'Promoting Interoperability'
CMS overhauls meaningful use as 'Promoting Interoperability'
Medicare & Medicaid
Hospitals can bill for treatment outside their four walls in new regulatory flexibility
Hospitals can bill for treatment outside their four walls
Patient Engagement
Better data sharing between payers, providers can move the needle on social determinants of health
How data sharing can improve SDOH
Pharmacy
AHIP supports federal regulation of PBMs in Supreme Court case
AHIP supports federal PBM regulation in Supreme Court
Population Health
United Health Foundation donates $5 million to support the homeless, food insecure, during COVID-19 crisis
UnitedHealth donates $5M to help the homeless
Risk Management
Cybersecurity needs to be put in business terms
Cybersecurity needs to be put in business terms
Telehealth
Virtual health: From Camp Fire to coronavirus
Virtual health: From Camp Fire to coronavirus
Mergers & Acquisitions
BMC Hospital to buy Bayonne Medical Center in New Jersey
BMC Hospital to buy Bayonne Medical Center
View more

Blog

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Dec 23, 2015 | Healthcare Finance Staff
Payers must change dynamic with providers to survive in the post-Affordable Care Act world
Finding the path to success in the post-Affordable Care Act world of ...
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Dec 22, 2015 | Healthcare Finance Staff
Affordable Care Act rate stabilization program results should guide strategy for 2016
Earlier this year, the Centers for Medicare and Medicaid Services released the ...
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Nov 03, 2015 | Healthcare Finance Staff
Plans should be prepared for the difference between operational and financial success
In the first part of this series, we looked at a transformative year in ...
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Nov 03, 2015 | Healthcare Finance Staff
Engaging providers means aligning their goals with that of the consumer
In our last column, we took a look at how U.S. health plans operate in a world of rising ...
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Nov 03, 2015 | Healthcare Finance Staff
Transforming provider relationships is key to engaging consumers
U.S. health plans today operate in a world of rising expectations. They must work to contain rising ...
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Oct 15, 2015 | Healthcare Finance Staff
RAPS, EDPS and risk adjustment: the health plan perfect storm
Commercial and government programs have witnessed a busy year -- most notably with the first year of ...
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Sep 25, 2015 | Healthcare Finance Staff
All signs point to value-based care: Are you ready?
With the current shift to value-based reimbursement, providers are facing noteworthy changes as healthcare ...
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Sep 17, 2015 | Healthcare Finance Staff
Setbacks and successes: What we've learned from the first year of commercial risk adjustment
Qualified health plans completed their first year of commercial ...
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Aug 06, 2015 | Healthcare Finance Staff
CEO pay ratio rule, inequality debate could pressure healthcare
Though still a major source of middle class jobs, healthcare companies, including consolidating ...
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Jul 31, 2015 | Healthcare Finance Staff
Praluent is not like Sovaldi
A few reasons why the want-to-be cholesterol blockbuster Praluent will not be as much of a "budget buster" as the ...
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