Healthcare Reimbursement News

Addressing the social determinants of health

Nancy Johnson, CEO of El Rio Community Health Center in Tucson, talks about her organization’s processes for addressing the social determinants of health among its patient population. The interview is a follow-up to a panel discussion at HFMA's 2019 Thought Leadership Retreat. Also in this episode: insights on effective leadership of teams and pricing strategy objectives.

By Erika Grotto January 13, 2020

Atrius Health: Experience with global-risk contracts paves way to success in new arrangement

Previous success in risk-based contracts will allow Atrius Health to thrive in its new global-risk arrangement with Blue Cross Blue Shield of Massachusetts, two of the provider’s leaders write.

By Patrick Holland January 13, 2020

Number of Medicare ACOs stays flat, but risk-taking increases

The number of Medicare ACOs has stagnated, but many more are taking on financial risk.

By Rich Daly January 13, 2020

Cautionary tales: Why some payer-provider initiatives have stumbled

Health system leaders that are considering launching a provider-sponsored health plan can take a lesson from the experiences of organizations that faced challenges in pursuing such a strategy.

By Richard Weil, PhD January 10, 2020

Many voters oppose giving government authority to set all healthcare prices

More voters oppose broad government rate-setting than support such an approach to addressing healthcare cost increases, according to a poll.

By Rich Daly January 9, 2020

More physicians shift from MIPS to APMs in Medicare

Increasing numbers of physicians paid by Medicare are shifting from the default quality-reporting-based payment option to earning bonus payments by participating in other payment models.

By Rich Daly January 8, 2020

Limits on savings from bundled payments identified in new research

Bundled payment program savings appear limited to lower joint replacement, and changes may be needed to improve the programs, according to new research.

By Rich Daly January 7, 2020

CMS extends comment period for health plan price transparency rule

CMS will accept feedback for an additional two weeks on a proposed rule requiring health plan price transparency.

By Rich Daly January 6, 2020

Auth-DP software helps streamline prior authorizations to reduce denials

A leading revenue cycle technology company talks about how its innovative prior authorization software streamlines the process of checking for, obtaining and following up on prior authorizations, saving organizations millions in avoided denials.

By HFMA January 2, 2020

Payer-provider partnership success stories

Partnering with a health plan has been shown to be an effective strategy for health systems undertaking a value-based payment strategy.

By Richard Weil, PhD January 2, 2020
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