Medicare & Medicaid

Sep 17 | Jeff Lagasse

CMS issues roadmap for states to accelerate adoption of value-based care

The agency said the roadmap stresses the importance of multi-payer alignment in value-based care to drive care…

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Sep 16 |

CMS is now accepting grant applications from rural communities to improve healthcare

The amount of upfront and monthly payments will vary based on the level of risk that the ACO accepts in…

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Sep 15 | Susan Morse

CMS proposes using only encounter data for Medicare Advantage risk adjustment and payment

The proposal is being released early for plans to better address estimating 2022 costs, in light of…

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Sep 15 | Jeff Lagasse

With price transparency an inevitability, hospitals need to start working toward compliance

Meeting the objectives of the final rule will be necessary to ensure compliance by January 1.

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Sep 15 | Susan Morse

541 ACOs in the Medicare Shared Savings Program saved Medicare $1.2 billion in 2019

Organizations such as the National Association of ACOs urge reforms to increase ACO growth and savings.

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Sep 11 |

Beneficiaries' lack of Medicare knowledge could lead to dissatisfaction in plans

Survey results indicate a need for people to become better informed about their coverage, which is both a…

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Sep 11 |

In recent weeks several major drugmakers have stopped providing 340B pricing for safety net hospitals

In recent weeks several major drugmakers have stopped providing 340B pricing for safety…

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Sep 10 |

Humana adds two new value-based payment programs for select Medicare Advantage plans

The programs are for coronary artery bypass grafting and shoulder replacements and incentivize clinicians…

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Sep 09 | Jeff Lagasse

Health system clinicians perform better under Medicare value-based reimbursement

Those linked to health systems were 99% less likely to receive penalties and 29% more likely to receive…

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Sep 04 | Jeff Lagasse

Half of Medicare patients did not receive recommended healthcare after hospitalization

Only 54% of Medicare patients referred to home healthcare services following a hospitalization received…

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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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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.

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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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