Medicare & Medicaid

Mar 30 | Susan Morse

Hospitals can bill for treatment outside their four walls in new regulatory flexibility

CMS is also allowing ERs to use drive-through testing and telehealth, and for tests to be done at home…

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Mar 30 | Susan Morse

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

Anthem claims the DOJ has violated the law in holding Medicare Advantage plans to payment standards…

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Mar 23 | Susan Morse

CMS relaxes hospital, nursing home inspections

On-site inspections will continue at certain facilities, such as the Life Care Center in Kirkland, Washington, where 26 residents died.

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Mar 19 | Jeff Lagasse

CMS issues recommendations on adult elective surgeries, nonessential procedures during COVID-19

Healthcare providers should encourage patients to remain home unless there is an emergency to…

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Mar 17 | Jeff Lagasse

Prescription Drug Pricing Act would save more than $94 billion in the first decade, CBO says

The savings are due in part to strict price-reporting controls on pharmaceutical companies and…

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Mar 17 | Jeff Lagasse

Coronavirus pandemic makes universal healthcare more popular in latest Morning Consult poll

Twenty-six percent of U.S. adults say they're "much more likely" to support such…

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Mar 13 | Susan Morse

President Donald Trump declares the coronavirus a national emergency

The designation frees up billions in funding for states and relaxes rules for providers and the federal government.

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Mar 13 | Jeff Lagasse

Medicare Advantage plans save beneficiaries up to $1,600 a year more than regular Medicare

Low-income beneficiaries are more likely to choose Medicare Advantage, and they assume less…

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Mar 13 | Susan Morse

UPDATED: Hospitals, physicians, nurses ask for coronavirus disaster declaration

President Trump is expected to make an emergency disaster declaration today at 3 p.m

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Mar 11 | Susan Morse

Insurance CEOs meet with President Trump, pledge coverage for coronavirus

CMS has provided flexibility to Medicare Advantage and Part D plans on testing, treatment and prevention.

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Featured Resources

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.

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?

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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 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.

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. ...

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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 ...

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