Policy and Legislation

OIG: Medicare overpaid $367 million for physical therapy

Mar 26 | Beth Jones Sanborn

Medicare overpaid $367 million for outpatient physical therapy in six-month stretch, OIG audit finds

Government watchdog estimated that during a 6-month audit period, Medicare paid hundreds…

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Mar 23 | Susan Morse

Senate passes spending bill without insurance stabilization; Trump signs after threatening veto

Insurers in the individual market are starting work on setting premium rates for this October…

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CMS proposes rule to alleviate Medicaid reporting burden

Mar 22 | Susan Morse

CMS proposes rule to help alleviate state burden in Medicaid reporting

States qualify by having at least 85 percent of their Medicaid population in managed care or by reducing provider…

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Mar 22 | Susan Morse

House passes new funding bill; here's what it means for federal health agencies

Insurers get no federal funds for cost-sharing reduction payments or a reinsurance program to help stabilize…

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Mar 21 | Jeff Lagasse

Affordable Care Act mandate repeal is driving prices up, customer choice down in individual insurance market

The government's repeal of the ACA's individual mandate has threatened…

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CBO: Health Care Stabilization Act would create $19 billion deficit

Mar 21 | Susan Morse

Congressional Budget Office says Bipartisan Health Care Stabilization Act of 2018 would create $19 billion deficit

As Congress debates appropriations legislation with the Friday deadline…

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What US health orgs need to know about Europe’s GDPR privacy law

Mar 21 | Jessica Davis

Europe's GDPR privacy law is coming: Here's what US health orgs need to know

By May 25, U.S. providers caring for EU patients will need to brush up on consent forms, data sharing and privacy…

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Mar 20 | Bernie Monegain

Kalorama highlights top 7 healthcare market disruptors

Factors that the research firm said are creating an era of uncertainty in the healthcare industry.

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Mar 19 | Susan Morse

President Trump promises death penalty for drug dealers, accountability for manufacturers, to combat opioid crisis

An electronic prescription drug monitoring program network would track…

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Crawford alleges CVS business practices created an emergency situation in his home state

Mar 19 | Beth Jones Sanborn

Congressman blasts CVS Health, Aetna merger, asks for deeper investigation

Arkansas Rep. Rick Crawford alleged CVS business practices created an emergency situation in his home state, calls…

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Featured Resources

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?

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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Top 10 healthcare issues to watch in 2016

CMS cancels mandatory bundles, reduces joint model participation

Docs must now explain 'observational' statuses

List: 769 hospitals fined for medical errors, infections

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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 ...

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.

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