Topics
Reimbursement
Private health plans pay providers at 241 percent of what Medicare would pay
Private health plans pay 241% of Medicare rate
Revenue Cycle Management
Astria Health blames revenue cycle contractor for bankruptcy
Astria Health files for bankruptcy, blames rev cycle contractor
Strategic Planning
Health systems diversify to grow their business
Health systems diversify to grow their business
Capital Finance
Healthcare spending accelerated during the first quarter, whilep price growth climbed slightly
Spending accelerated in Q1, while price growth climbed
Supply Chain
Group purchasing organizations reduce supply costs by 13.1 percent
GPOs reduce supply costs by 13.1 percent
Accounting & Financial Management
Community Health Systems sees major drop in net losses over 2017, reporting $328 million for Q4 2018
CHS reports major drop in net losses for Q4 2018
Budgeting
New clinical pathway for cancer patients leads to better outcomes, lower healthcare costs
New clinical pathway lowers healthcare costs
Quality and Safety
Quality standards framework can improve both clinical and financial performance in healthcare
How a healthcare quality workforce can better care, costs
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
With medical groups employing more physicians, a leader with the right skill set is paramount
Finding the right medical group leader
Operations
UnitedHealthcare leads healthcare's 25 most valuable brands
UnitedHealthcare tops healthcare's most valuable brands
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
Northwell Health, NYC Health + Hospitals open new $47.7 million joint lab to help hospitals focus on emergency testing, cut costs
Northwell Health, NYC Health + Hospitals open new $47.7M joint lab
Compliance & Legal
Chinese nationals indicted for Anthem hack from 2014
Chinese nationals indicted for Anthem hack
Policy and Legislation
President Trump calls for an end to surprise medical bills
President Trump calls for an end to surprise billing
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
UnitedHealthcare introduces new bundled payment program for maternity care
UnitedHealthcare unveils bundled payment program for maternity care
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
Focus on Precision Medicine
Focus on Precision Medicine
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
Private insurers in California pay more than double what Medicare does for similar services
Private CA insurers pay more than double that of Medicare
Patient Engagement
Vast majority of patients would show more loyalty to providers if they had access to holistic health and wellbeing support
Improving patient loyalty with holistic health support
Pharmacy
Precision medicine as a way to improve oncology care -- and potentially drive down drug costs
How precision medicine in oncology can lower costs
Population Health
Screenings for social determinants of health need to be tailored to clinics, BU finds
SDOH screenings need to be tailored for clinics
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
With telehealth still evolving as a care delivery model, text-based care may offer the best quality for some patients
Text-based telemedicine: The next evolution?
Mergers & Acquisitions
Healthcare mergers and acquisitions require sensible data sharing strategies, and a solid analytics framework
Successful healthcare M&A requires a solid analytics framework
View more

Out-of-Pocket Payments

In-depth

Part D plans required to give drug pricing information through electronic prescribing or EHR

Part D plans required to give drug pricing information through electronic prescribing or EHR

Pharmacy groups express frustration that CMS did not reform direct…

Mental health patients insured by marketplace health plan less likely to receive a medical appointment

Mental health patients insured by marketplace health plan less likely to receive a medical appointment

Success was highest for those with employer coverage…

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

May 20, 2019 | Susan Morse

Part D plans required to give drug pricing information through electronic prescribing or EHR

May 10, 2019 | Jeff Lagasse

Mental health patients insured by marketplace health plan less likely to receive a medical appointment

May 10, 2019 | Jeff Lagasse

Health plan customer satisfaction challenged by new era of empowered healthcare consumers

May 8, 2019 | Susan Morse

Reimbursement, regulation, resistance to change remain provider barriers to precision medicine

May 3, 2019 | Susan Morse

Congressional Budget Office looks at impact of Medicare for All

May 2, 2019 | Susan Morse

Health systems need to collect patient balances

April 29, 2019 | Susan Morse

How hospitals are making investments that create new revenue streams

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Anthem accelerates start for PBM IngenioRX

Anthem accelerates start for PBM IngenioRX

IBM Watson Health lists top 15 health systems

IBM Watson Health lists top 15 health systems

Gender, minority bias revealed in med student evals

Gender, minority bias revealed in med student evals

List: 769 hospitals fined for medical errors, infections

List: 769 hospitals fined for medical errors, infections

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Hospitals investing to create revenue streams

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Optum: UnitedHealth's secret weapon

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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…

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.

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.

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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.

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…