Health Plan Payment and Reimbursement

Healthcare News of Note: UnitedHealth Group can proceed with Change Healthcare purchase after a favorable decision in an antitrust case

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: UnitedHealth Group cleared to acquire Change Healthcare, standard patient satisfaction surveys need to address DEI issues, and homebound older adults contribute to higher levels of Medicare spending.

Deborah Filipek September 26, 2022

Surprise-billing arbitration updates include a lawsuit and new context on rate-setting approaches

A provider association that earlier won a lawsuit over the No Surprises Act arbitration process is going to court again over the same issue.

Nick Hut September 23, 2022

Hospitals issue plea for healthcare policymakers to do more to buttress the industry

The American Hospital Association and hospital leaders say recent financial trends are unsustainable for many organizations.

Nick Hut September 20, 2022

PMMC’s Contract PRO helps hospitals see an average 10 to 1 ROI

When the time comes to renegotiate payer contracts, one company’s contract management system “provides managed care leaders with the ability to model all commercial payer contract terms to quickly understand the impact on net revenue.”

HFMA August 31, 2022

TransUnion Medicare DSH solution helps hospitals identify reimbursement opportunities

Medicare disproportionate share hospital payments payments help serve low-income populations, but comes with a set of challenges such as identifying eligible patients. See one company’s solution by leveraging unique processing and data integration.

HFMA August 31, 2022

Waystar simplifies existing revenue cycle systems for more effective payment

With the industry’s largest SaaS RCM platform, one company surrounds and supplements health systems’ existing systems to simplify healthcare payments.

HFMA August 31, 2022

What revenue cycle strategies enhance the patient experience

In a roundtable discussion, revenue cycle leaders chat about strategies they developed to enhance the patient experience while navigating the payment process.

HFMA August 31, 2022

The shift toward integrated pharmacy services: driving long-term success

One driving factor for health systems and hospitals shift to in-house integration pharmacy services is average turnaround time. For an outsourced specialty pharmacy, turnaround is 10 to 14 days, whereas an in-house specialty pharmacy can reduce that time to just 2.1 days.

HFMA August 31, 2022

HFMA’s virtual revenue cycle and price transparency series focuses on helping health systems re-engage consumers and improve financial performance

Beginning March 1, healthcare finance professionals can participate in several educational sessions and peer-to-peer discussions by enrolling in HFMA's virtual revenue cycle and price transparency workshop.

Deborah Filipek August 26, 2022

Final rule appears to give a boost to providers in No Surprises Act arbitration cases

A new final rule codifies updated criteria for deciding arbitration cases under the No Surprises Act, with providers potentially coming out ahead relative to last year’s interim final rule.

Nick Hut August 22, 2022
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