Administrative prior authorization requirements increasingly used to steer patients to lower-cost settings
Hospital finances could be significantly impacted by UnitedHealthcare’s expansion of site-of-service prior authorization requirements going into effect Nov. 1.
Analysis: What to expect after the Texas vs. Azar ruling
There’s still much to be argued and dealt with regarding Texas versus Azar, and no final decision on the ACA should be expected until June 2020 at the earliest.
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.
Nov. 4-8: A Medicare advisers meeting is among the week’s national healthcare events
The Medicare Payment Advisory Commission’s two-day public meeting is among major healthcare finance events taking place this week.
HFMA: CMS transparency effort misses the mark
Podcast: HFMA President and CEO Joe Fifer discusses HFMA’s perspectives regarding a CMS proposed rule that has generated controversy in that it would require the public release of rates hospitals negotiated with health plans.
3 ways cost models are a key to success under risk
Business Intelligence: New primary care models can help healthcare organizations achieve financial goals.
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.
Broad trends are driving the imperative for hospitals to revisit cardiac care
A number of factors have contributed to declining revenue growth for hospitals' cardiac catheterization labs in recent years.
Evolution of the consumer focus in healthcare
The potential benefits of consumer-driven health plans were espoused in the 1990s, and the concept began to be more fully embraced in the past decade.
7 top macro trends impacting providers, insurers and healthcare consumers today
The healthcare industry's shift to a consumerism focus is occurring in parallel with seven significant emerging trends that are affecting providers, insurers and healthcare consumers alike.