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

Compliance & Legal

In-depth

Landmark $115 million settlement reached in Anthem data breach suit, consumers could feel sting

Landmark $115 million settlement reached in Anthem data breach suit, consumers could feel sting

Per agreement, lawyer fees will soak up a third of the $115…

CMS lightens the reporting load for Medicare Advantage, Part D, changes how star ratings are calculated

CMS lightens the reporting load for Medicare Advantage, Part D, changes how star ratings are calculated

Proposed rule would update star rating methodology, save…

Whitepapers

Quality Payment Program Year 2: An Overview of the Proposed Rule

Quality Payment Program Year 2: An Overview of the Proposed Rule

Are there changes from the first year? What is in year two? What else do you need to know?…

Choosing the Best Health Risk Assessment

Choosing the Best Health Risk Assessment

An HRA lays a foundation for a good employee wellness program, personalized prevention plan, or population health…

Latest News

March 30, 2020 | Susan Morse

DOJ accuses Anthem of fraud in risk adjustment payments for its Medicare Advantage plans

March 23, 2020 | Mike Miliard

CMS offers quality reporting relief as providers battle COVID-19

March 2, 2020 | Jeff Lagasse

FTC and Pennsylvania challenge proposed merger of two Philly hospital systems

February 28, 2020 | Jeff Lagasse

Michigan doc charged in $120 million healthcare fraud, money laundering scheme

February 26, 2020 | Mike Miliard

AMA launches new playbook to help providers with digital record sharing

February 25, 2020 | Susan Morse

Appeals court upholds Trump Administration rule barring abortion referrals

February 24, 2020 | Jeff Lagasse

Affordable Care Act exchanges grow as insurer participation rises

VIEW ALL NEWS

MostPopular

CMS issues coronavirus elective surgeries recommendations

CMS issues coronavirus elective surgeries recommendations

List: 769 hospitals fined for medical errors, infections

List: 769 hospitals fined for medical errors, infections

Getting paid for virtual care services: Codes to know

Getting paid for virtual care services: Codes to know

64% of surgical staff hoard, waste or overuse supplies

64% of surgical staff hoard, waste or overuse supplies

COVID-19: Health workers risk exposure, burnout

COVID-19: Health workers risk exposure, burnout

Optum: UnitedHealth's secret weapon

Optum: UnitedHealth's secret weapon

See the first star ratings for home health

See the first star ratings for home health

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…

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.

Whitepapers

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…

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…

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.