Topics
Reimbursement
UnitedHealthcare to start covering medical implant for sleep apnea
UHC to start covering medical implant for sleep apnea
Revenue Cycle Management
Hospital CEOs focus on revenue growth over cost containment, according to new survey
CEOs are focused on revenue over cost
Strategic Planning
U.S. Attorney Cynthia Ridgeway will take strategic job with Anthem
U.S. Attorney Cynthia Ridgeway to take job with Anthem
Capital Finance
Precision medicine: Barriers to investment
Precision medicine: Barriers to investment
Supply Chain
Group purchasing organizations reduce supply costs by 13.1 percent
GPOs reduce supply costs by 13.1 percent
Accounting & Financial Management
Finding unconventional sources of capital in the face of revenue pressures
Finding hidden sources of capital
Budgeting
New clinical pathway for cancer patients leads to better outcomes, lower healthcare costs
New clinical pathway lowers healthcare costs
Quality and Safety
Majority of U.S. hospitals not meeting surgical safety standards
Most hospitals not meeting surgical safety standards
Billing and Collections
Medical costs create hardships for more than half of Americans
Medical costs a hardship for most Americans
Claims Processing
BCBS Institute and Solera partner, pay SDoH organizations through outcomes-based medical claims
BCBS Institute, Solera, to pay organizations through outcomes-based claims
Workforce
Health insurers must get creative with benefits to fill critical vacancies
Insurers must get creative to fill critical vacancies
Operations
David Callender is new president and CEO of Memorial Hermann Health
David Callender is new president, CEO of Memorial Hermann
Medical Devices
Apple is developing custom health information tracking chips
Apple is developing custom health chips
Hospital/physician relations
Wording in medical student evaluations differ by gender, minority status, revealing potential bias
Gender, minority bias revealed in med student evals
Construction & Facilities Management
Kaiser Permanente plunking down $900 million on new Oakland headquarters
Kaiser Permanente building $900M HQ in Oakland
Compliance & Legal
Affordable Care Act heads to appeals court on Tuesday
ACA heads to appeals court on Tuesday
Policy and Legislation
Insurers applaud end of Cadillac tax
Insurers praise end of Cadillac tax
Community Benefit
Kaiser Permanente commits $1.65 million to California wildfire relief efforts
Kaiser Permanente commits $1.65 million to California wildfire relief efforts
Accountable Care
CMS has 2019 Medicare ACO class
CMS has 2019 Medicare ACO class
Acute Care
University of Chicago Medicine study shows need to enhance patient rest, evaluate overnight interruptions for better patient experience
University of Chicago Medicine study shows how to help patients rest for improved experience
Ambulatory Care
Medical schools, teaching hospitals account for 3% of US GDP, report shows
Med schools, teaching hospitals are 3% of GDP
Analytics
Innovaccer research shows how AI could improve cost of care models
Innovaccer research shows how AI could improve cost of care models
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
New CMS resources help states waive ACA requirements
New CMS resources help states waive ACA requirements
Patient Engagement
Age, race disparities found in the use of hospital patient portals
Age disparities found in patient portal use
Pharmacy
Trump administration withdraws drug rebate rule
Trump administration withdraws drug rebate rule
Population Health
Social determinants of health data can be difficult to collect and share, but it's imperative to success
SDOH data hard to share, but necessary
Risk Management
Hospital employees are clicking on phishing emails, and that's a problem, JAMA study shows
JAMA: Hospital employees are clicking on phishing emails
Telehealth
Telemedicine market expected to account for more than $38 billion by 2029
Telemedicine worth $38 billion by 2029
Mergers & Acquisitions
Court decision expected soon in CVS\Aetna merger
Court to hand up a decision soon in CVS\Aetna merger
View more

Highmark

In-depth

Three largest insurers dominate market share in at least 37 states, GAO report says

Three largest insurers dominate market share in at least 37 states, GAO report says

Blue Cross was the most named, largest insurer in 10 states in which three…

Highmark saves $260 million in avoidable healthcare costs through PCP value-based program

Highmark saves $260 million in avoidable healthcare costs through PCP value-based program

The insurer rewards physicians in care coordination reimbursements.

Whitepapers

Global Innovators

Global Innovators

Healthcare digitization is still often perceived as being an endeavor on the level of the individual healthcare system or nation state. While…

The Evolution of Utilization Review and Its Impact on Revenue Integrity

The Evolution of Utilization Review and Its Impact on Revenue Integrity

Existing utilization review (UR) paradigms are no longer suitable for addressing the…

Latest News

March 22, 2019 | Susan Morse

Three largest insurers dominate market share in at least 37 states, GAO report says

June 28, 2018 | Susan Morse

Highmark saves $260 million in avoidable healthcare costs through PCP value-based program

April 6, 2018 | Susan Morse

Health plans look to collaborations to gain data, interoperability and efficiencies

March 20, 2018 | Susan Morse

Highmark Health posts $1.1 billion in income and points to ACA business among the reasons

December 28, 2017 | Susan Morse

10 top healthcare finance trends of 2017

December 20, 2017 | Bernie Monegain

Aledade gets boost for ACO business with $23 million in new funding

September 1, 2017 | Susan Morse

PinnacleHealth joins UPMC to become UPMC Pinnacle

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MostPopular

Anthem accelerates start for PBM IngenioRx

Anthem accelerates start for PBM IngenioRx

List: 769 hospitals fined for medical errors, infections

List: 769 hospitals fined for medical errors, infections

See the first star ratings for home health

See the first star ratings for home health

Optum: UnitedHealth's secret weapon

Optum: UnitedHealth's secret weapon

Value-based care requires payer and provider collaboration

Value-based care requires payer and provider collaboration

List: CMS 2019 Star ratings show Kaiser on top

List: CMS 2019 Star ratings show Kaiser on top

UnitedHealthcare's new CEO is Dirk McMahon

UnitedHealthcare's new CEO is Dirk McMahon

News

Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades

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. But with more patients weighing public hospital grades, experts, as well as a few…

Analyze this: Health systems, health plans get to the core of big data

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.

Healthcare mergers and acquisitions in 2016: Running list

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.

Whitepapers

Clinical Quality Measures 101

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…

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

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 that's already flowing through financial systems into…

Credible, Defensible Estimates

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.