Policy and Legislation

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 11 | Susan Morse

AHIP, healthcare organizations, advocate for federal standard to prevent surprise medical bills

Millions of consumers receiving surprise medical bills blame their insurer or provider.

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Dec 10 | Susan Morse

CMS finalizes rule on risk adjustment for 2018

Final rule allows insurers to get funds and sustain premiums for a more stable ACA market.

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Dec 07 | Susan Morse

ACA enrollment down 11.2 percent, with one week left to go

Of the 3.2 million consumers selecting plans, 75 percent are renewing their coverage.

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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 04 | Susan Morse

Federal judge challenges CVS Health, Aetna merger

While integration of CVS Health and Aetna has begun, judge has ordered both parties to submit arguments by December 14.

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Nov 29 | Susan Morse

Trump Administration proposes using ACA subsidies to buy non-Obamacare health insurance

Democrats demand answers to what they call a sabotage of the ACA.

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Nov 29 | Jeff Lagasse

Detroit Medical Center hospitals may lose federal funds due to health and safety violations

At issue were infection control violations, which the Centers for Medicare and Medicaid Services…

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Nov 26 | Susan Morse

ACA enrollment continues to fall; Insurers have 3 weeks to make gains

This year, 1.92 million people have selected plans, compared to 2.27 million last year when open enrollment began a day…

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Nov 21 | Jeff Lagasse

Report shows strong but uneven spending in medical and health R&D across sectors over five-year period

Industry, the federal government and the National Institutes of Health were all…

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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?

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.

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.

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News

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.

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. ...

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 ...

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 ...

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