Providers Should Keep Watch on Payer Discount Increases
A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.
What Changes Are Coming to Medicaid in 2019?
Oct. 16—Additional state expansions of Medicaid eligibility are among the expected developments coming next year to the program, according to a former federal leader of Medicaid.
Keeping Up-To-Date on Shifting Medicaid Eligibility Laws
A government affairs expert shares strategies for keeping up with complex Medicaid rules and stay in compliance.
Getting Proactive About Bundles
Building on lessons learned from early bundle experiences, a midwestern health system is proactively designing its own bundles as it works with insurers and the state to craft bundles that better represent clinical and operational realities.
Medicaid Plans, Hospitals Clash over Proposed Kids Model
Sept. 5—Medicaid insurance companies and hospitals squared off in Congress this week over legislation to expand children’s medical homes nationally.
Why Fee-For-Service Remains Prominent
Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.
How to Really Know Your Payment Rates
A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.
Maryland Insurance Costs Rise Despite Hospital Price Controls
July 24—Despite a unique price control system for Maryland hospitals, insurers in the state’s Affordable Care Act (ACA) individual health insurance market have requested the largest average rate increase in the country.
3 Strategies for Taking Control of Payer Management
Three strategies can help hospitals and health systems prioritize payer contract management.
Congress Pushes 340B Bills to Cut Eligibility, Increase Reporting
July 11—Members of Congress this week pushed emerging legislation to restrict the ability of hospitals and other providers to qualify for the 340B discount drug program and to increase their reporting requirements.