Medicare & Medicaid

Jul 09 | Susan Morse

Insurers need flexibility in benefit design to continue telehealth past the public health emergency

CMS Administrator Seema Verma: The Centers for Medicare and Medicaid Services needs help…

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Jul 08 | Jeff Lagasse

Medicare's race, ethnic data often undercounts minority populations

Hispanics, Asian Americans and Native Americans are the groups most consistently misclassified, the data shows.

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Jul 08 | Susan Morse

Hospitals continue to bear the burden of the COVID-19 surge

The AHA is asking Congress for financial support with other relief in regulatory measures, the biggest being the use of telehealth.

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Jul 07 | Susan Morse

AHA, others urge HHS to delay price transparency rule due to COVID-19

The groups said the rule would pose a burden to hospitals and health systems responding to the COVID-19 public health…

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Jul 06 | Susan Morse

CMS proposes Medicare payment changes to increase the use of dialysis in the home

The proposed changes would encourage the development of certain new and innovative home dialysis machines,…

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Jun 30 |

Bright Health Plan to expand into new markets in 2021

It will expand access to its Medicare Advantage, individual and family-plan products, and to add fully-insured small business plans.

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Jun 29 | Jeff Lagasse

HHS has reduced backlog of Medicare appeals by almost half

The reduction is linked to a federal court ruling that established annual deadline-based targets.

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Jun 25 | Susan Morse

CMS issues its first proposal to continue telehealth flexibilities, in home health proposed rule

The proposed rule also updates home health payment rates for 2021.

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Jun 23 | Susan Morse

American Hospital Association to appeal ruling on price transparency lawsuit

A federal judge today sided with the Department of Health and Human Services and rejected providers' claims.

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Jun 23 | Susan Morse

Highmark, Kaiser, Humana rank highest for satisfaction in study of Medicare Advantage plans

MA plan members want more information on telehealth, according to the J.D. Power U.S. Medicare…

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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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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.

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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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