Health Plan Resources

A collection of resources to help health plan leaders navigate the challenges and opportunities in this new era of health care.

Resources

News | Innovation and Disruption
The U.S. healthcare industry is undergoing a reframing to correct glaring problems, said clinical executive Zeev Neuwirth during the opening keynote presentation of HFMA’s 2022 Annual Conference.
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Blog | Health Plan Payment and Reimbursement
Study results indicate that ongoing litigation over the independent dispute resolution process established by the No Surprises Act may not have a major impact on outcomes.
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Executive Roundtable | Value-Based Payment
In this roundtable, executives for health plans and health systems share challenges in value-based care and the significance of moving away from fee-for-service toward value-based-care.
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News | Innovation and Disruption
The U.S. healthcare industry is undergoing a reframing to correct glaring problems, said clinical executive Zeev Neuwirth during the opening keynote presentation of HFMA’s 2022 Annual Conference.
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News | Medicare Payment and Reimbursement
In separate cases, the Supreme Court said HHS’s formula for determining DSH payments is statutorily correct and that health plans can limit outpatient dialysis coverage.
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News | Medicare Payment and Reimbursement
In a 9-0 ruling, the Supreme Court said CMS didn’t have the authority to lower drug reimbursement amounts for 340B hospitals as it did in 2018 and 2019.
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Blog | Health Plan Payment and Reimbursement
Study results indicate that ongoing litigation over the independent dispute resolution process established by the No Surprises Act may not have a major impact on outcomes.
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Blog | Patient Experience
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: A new study shows the patient experience worsened mid-pandemic, researchers are using machine learning to discover more about long-COVID, and...
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Blog | Medical Necessity
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
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