Managing and Measuring Payer Performance
Healthcare providers should have a contract management system as the framework for managing the four components of the governance/communication processes―contract analysis and modeling, payment calculations, variance monitoring workflow, and payer scorecard and reporting.
Executive Summary: CMS Quality Payment Program 2018 Proposed Rule
This document briefly summarizes the Quality Payment Program 2018 proposed rule published by CMS.
Facing MACRA Without Fear
David Lareau offers insights into the future of the Medicare and CHIP Reauthorization Act of 2015.
Physician Partnerships in the Era of ACA Repeal and Replace
Bundled care for the uninsured may presents an effective solution to the looming challenges facing the healthcare industry.
How Finance Can Play a Pivotal Role in the Transition to MACRA
As a central entity in a healthcare practice, the finance department is in a unique position to review processes and implement improvements as the MACRA transition begins.
Overview of the Better Care Reconciliation Act as Drafted on June 28, 2017
This presentation summarizes the Better Care Reconciliation Act as drafted on June 28, 2017.
Video: Key Points of Focus for Hospitals: CMS Strategy, Bundled Payment, and Cost of Care
Larry Goldberg, principal, Larry Goldberg Consulting, takes a look at bundled payments, quality outcomes, and the cost of providing services.
Managing Care Variation: Optimizing Total Joint Replacement Bundle
Advisory Board’s Sean Angert discusses ways healthcare organizations can improve performance in bundled payment programs.
No-Pay Policy for Non-Emergent ED Use Spreading
A growing number of health plans are not paying for non-emergency patient use of the ED.
Bad Debt, Charity Care Contribute To Differences in Patient Revenue
Low margin hospitals may be receiving reduced payments from commercial insurance, which may contribute to their lower net patient revenues.