Medicare & Medicaid

Dec 11 | Susan Morse

CMS extends enrollment deadline for consumers who are asked to leave a message

The agency is allowing those who get a message from the marketplace call center to enroll in a plan after the…

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Dec 11 | Jeff Lagasse

What does expanded Medicaid mean for enrollees' health? A lot

Nearly half of people covered by Michigan's expanded Medicaid program felt that their physical health improved in the first…

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Dec 06 | Susan Morse

National healthcare spending growth slowed in 2017, CMS says

One reason is the decrease in spending on prescription drugs, from fewer opioids being dispensed to a drop in treatment for…

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Dec 06 | Susan Morse

American Hospital Association among those suing HHS over site neutral payments

The hospitals that rely on Medicare payments may have to cut services due to the $380 million payment…

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Dec 03 | Susan Morse

Value-based purchasing takes hold: More than half of hospitals paid as part of the program

Smaller and rural hospitals outpace urban providers in performance measures -- except for clinical…

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Nov 30 | Jeff Lagasse

Rates of hospitalization rising among homeless, study finds

Mental illness and substance use disorder are still the main driver of acute hospitalizations among homeless adults.

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Nov 30 | Susan Morse

ACA enrollment down 12.8 percent over last year

Insurers have two weeks left to sign-up consumers, as Trump Administration plans to allow ACA subsidies to cover non-Obamacare insurance.

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Nov 29 | Susan Morse

HHS implements long-awaited 340B drug price transparency rule

The rule directs pharmaceutical manufacturers to disclose the maximum per unit ceiling price that can be charged to 340B…

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Nov 27 | Susan Morse

Small and medium-sized health plans represent 83 percent of market

Medicare Advantage, managed Medicaid and provider-sponsored plans, represent the bulk of the SMB market.

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Nov 26 | Susan Morse

CMS proposes giving Part D plans greater negotiating power with drug manufacturers

CMS is proposing to give Medicare Part D drug plans flexibility to negotiate discounts for drugs in…

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Featured Resources

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?

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.

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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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.

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 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 ...

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.

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