Innovation, payer reinvention, drug prices and price transparency, cybersecurity, getting paid for telehealth and investing in the social determinants as well as the continuing physician workforce shortage topped HFN's stories and trends for 2019. Here's a look back.
It's the unanticipated consequence of the 2017 cut of the ACA's cost-sharing reduction payments to health insurers.
Health plans doing business in Medicare, Medicaid, ACA, are being asked to share claims data, and all information should be transferable, Verma says.
The rule will accelerate anti-competitive behavior among health insurers and stymie innovations in value-based care delivery, the groups say.
The government-wide MyHealthEData initiative is led by the White House Office of American Innovation.
The HFN team discusses some recent pieces of news from federal and state governments, and speculates on these developments.
The insurance group says it's supportive of more data sharing, but says CMS' timeline for API-enabled access is too aggressive.
At Maricopa Integrated Health System, price transparency became a top strategic imperative after it helped the system boost its margins.
CMS Administrator Seema Verma says agency is not afraid of legal push-back from providers or payers.
CMS releases final and proposed rules on price transparency bound to get provider and payer pushback
The final rule for hospitals, which goes into effect in 2021, includes the ability for CMS to impose civil monetary penalties of $300 per day.
The Omnibus Burden Reduction and Discharge Planning rules both aim to reduce red tape and enable transparency, says Centers for Medicare & Medicaid Services Administrator Seema Verma.
Legislative proposals could reduce bad debt, but would likely introduce additional complexity to billing processes.