Medicare & Medicaid

Feb 21 | Susan Morse

CMS launches podcast to discuss policies and agency updates

First "CMS: Beyond the Policy" podcast explains physician fee schedule for 2019, in a conversational format.

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Feb 15 | Susan Morse

New ambulance payment model will reimburse for on-site treatment, use of telehealth

The 5-year model is testing for treatment in place of and for emergency transport to an alternative…

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Feb 13 | Susan Morse

CMS Administrator Seema Verma lays out plan for 'digital data revolution'

Health plans doing business in Medicare, Medicaid, and the ACA are being asked to share claims data, and all…

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Feb 07 | Jeff Lagasse

Medicare rules increase out-of-pocket costs of multiple sclerosis drugs

Medicare beneficiaries without low-income subsidies can expect to spend $6,894 a year out-of-pocket for treatment of…

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Feb 05 | Jeff Lagasse

Medicare spending on healthcare for elderly dips, driven by better cardiovascular care

The findings make a fiscal case for increasing prevention efforts among patents of all ages, not just…

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Feb 01 | Jeff Lagasse

When it comes to new healthcare payment and delivery models, CFOs lack confidence

Finance leaders are worried about the changing landscape, and many feel unprepared for what's to come.

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Feb 01 | Susan Morse

Democrats, America's Health Insurance Plans denounce HHS plan targeting drug rebates

Community Oncology Alliance commends proposal to overhaul what it calls secretive drug rebate system that…

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Jan 30 | Susan Morse

Medicare Advantage revenue expected to increase 1.59 percent under proposed rate changes

For the first time, MA plans may lower cost sharing for drugs such as Naloxone, to treat opioid…

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Jan 28 | Jeff Lagasse

How artificial intelligence can be used to reduce costs and improve outcomes in total joint replacement surgery

Use of AI led to cost reductions including a 25 percent drop in hospital…

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Jan 25 | Beth Jones Sanborn

MGMA: Majority of practices say cost of care outweighs Medicare reimbursements

Massive gaps leave practices more dependent on reimbursement from commercial payers and commercial contracts,…

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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.

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?

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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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. ...

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

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.

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 ...

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 ...

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