March Toward Value-Based Care Slipping: Survey
July 18—A new survey of physicians and health plan execs says the march toward value-based care is slipping, throwing shade on other surveys that say the transition to outcomes-based payment is on track.
CY2019 Home Health Prospective Payment System Proposed Rule: HFMA Executive Summary
This document summarizes the proposed rule updating payment rates under the home health PPS for CY2019, published by CMS.
Payer access to EHR data improves cash flow
Sharp Healthcare gives some payers limited access to their members’ EHR data, which reduces the time-consuming cycle of level-of-care authorization denials, appeals, and ultimate approvals.
Medicare Physician Pay Rule Targets Reporting Burden
July 17—Physician advocates are hailing a range of Medicare policy changes that were included in a recently proposed payment rule and are aimed at reducing clinicians’ administrative burden.
CMS Tweaks BPCI-A Time Frames
July 16—Some key timing parameters of the next large Medicare alternative payment model were changed in recent weeks.
Colorado Healthcare System Increases Price Transparency for Self-Pay Patients
SCL Health shows self-pay prices in two ways—an average for a specific service and the range of prices charged in the past year. This helps set realistic expectations when prices are above average based on varying factors.
Self-Pay Transparency in Colorado: What the Law Says
Colorado’s Transparency in Direct Pay Health Care Prices Act requires health facilities to publish online the self-pay prices of their 50 most-used DRG codes and the 25 most-used CPT codes.
Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Exemptions to Anthem’s ED Policy
Anthem will not deny an ED claim based on the prudent layperson standard if certain conditions apply.
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.