Health Plan Payment and Reimbursement

One health system finds ‘millions’ of reasons to audit value-based payments

A health system identified millions of dollars in underpayments that it should have received as part of two value-based payment arrangements in recent years.

Rich Daly November 19, 2019

Administration finalizes requirement for hospitals to post rates paid by health plans

A newly finalized requirement will require hospitals to post rates that are privately negotiated with health plans, as well as rates for a list of 300 “shoppable services.”

Rich Daly November 15, 2019

Federal policy drives hospital-practice deals but not M&A between hospitals, MedPAC finds

Federal policy is not driving hospital M&A but is encouraging hospital purchases of practices, a key congressional advisory group said.

Rich Daly November 12, 2019

Transparency rule could come this month, White House executive says

A controversial requirement for hospitals to publicly post the rates they negotiate with health plans is expected this month, according to a senior White House official.

Rich Daly November 8, 2019

How hospital quality executives are pitching value-based payment to CFOs

Healthcare quality-improvement executives see ways in which an emphasis on value can improve some hospitals’ finances.

Rich Daly November 7, 2019

Healthcare reform moves to the states: Strategies to increase access and control costs

An increasing number of states are looking to improve access and reduce costs by funneling innovations, such as a public option or reinsurance program, through Medicaid.

Pam Nicholson, MBA November 5, 2019

Legislative fight over surprise billing is nearing an end, congressional aide says

Congressional negotiators are said to be close to a compromise on legislation that aims to end surprise medical bills.

Rich Daly October 31, 2019

More Medicaid programs increase hospital payment rates

More states have moved to increase hospitals’ Medicaid rates than to cut them — reversing a pattern from the last fiscal year.

Rich Daly October 22, 2019

Cup of Joe: Matt Eyles, CEO of AHIP

America's Health Insurance Plan President and CEO Matt Eyles discusses how health plans view price transparency and other issues facing the industry.

Erika Grotto October 15, 2019

Information imperatives for successful payer-provider collaboration

A roundtable of payer and provider leaders examines the importance of transparent communication, relationship-building and robust data sharing amid the transition to value-based care.

HFMA October 8, 2019
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