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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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Featured Resources

Care Collaboration Success for Improved Outcomes The nature of our healthcare ecosystem has been one of siloed care. Rarely do payers, providers and local resources come together with the patient's well-being prioritized as a unifying mission. Read how these organizations are getting it right.

Debunk the Myth: Outsourcing Doesn't Mean Losing Control With shifts in payer mixes and reimbursement structure, the margin of reimbursement has been shrinking steadily over the last five years. How do revenue cycle leaders navigate payment reform while maintaining stable business office operations?

Beyond Dollars and Cents: A Closer Look At Value Beyond the expected improvement in specific metrics, many organizations that outsource RCM with a trusted and certified partner are seeing several ancillary benefits of such agreements.

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Healthcare mergers and acquisitions in 2016: Running list While 2015 was a record-breaking year in healthcare mergers and acquisitions, 2016 saw more change as organizations across the industry adjust and adapt to the evolving financial landscape.

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades When Leapfrog released their Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. ...

Analyze this: Health systems, health plans get to the core of big data Pamela Peele knows that people who subscribe to cooking magazines have a much higher risk of going to the emergency room. But how she knows that is a whole other story.

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Credible, Defensible Estimates In healthcare, every interaction with the patient matters. Especially in today’s environment of continuous improvement, efforts have been concentrated on coordination among providers, the patient care experience and quality outcomes – all laudable goals.

Clinical Quality Measures 101 Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to report ...

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and better compete in their markets. The challenge many face is how to turn the data ...

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