Healthcare Reimbursement News

Protecting Revenue at Risk

A pocket guide to help hospitals and health systems navigate pay-for-value programs.

By Warren E. Beck March 21, 2018

Developing a Future Generation Integrated Healthcare System

To envision new and better ways to rapidly reduce healthcare costs, the U.S. healthcare industry should take a lesson from approaches used by other countries, including China.

By Keith D. Moore, MCP March 21, 2018

The Benefits of Direct-to-Employer ACO Arrangements

Clifford Fullerton, president of Baylor Scott & White Quality Alliance, describes a direct-to-employer accountable care organization arrangement that is improving patient access and care quality.

By Clifford Fullerton March 20, 2018

Value Initiative for IPA Performance Proves Its Worth

John Baackes, CEO of L.A. Care Health Plan, describes the plan’s approach to assessing the value of independent practice associations to ensure high-quality member service.

By John Baackes March 19, 2018

March 19-23 Policy Watch: Push to Include ACA Marketplace Stabilization in Funding Bill

March 15—Healthcare leaders are renewing their push to include a stabilization measure in a must-pass federal funding bill that is required by the end of next week.

By Rich Daly March 16, 2018

MACRA Improvements Coming, CMS Official Says

March 13—A series of regulatory changes are coming to the Medicare physician payment system this year, including an effort to ease quality-data reporting by hospital-employed physicians.

By Rich Daly March 14, 2018

Insurer Data Requests Prompt Hospital Policy Overhauls

March 12—As health insurers increasingly get involved in patient care management, they are requesting clinical data on individual patients from hospitals and health systems. 

By Rebecca Vesely March 12, 2018

Where Is the Federal Government Going on Value-Based Pay?

March 9—Comments from the leader of federal healthcare policy disparaging the leading value-based payment models and hinting at new directions left some industry analysts confused, but others saw evidence of emerging models.  

By Rich Daly March 9, 2018

Will CMS Allow Limits on Medicaid Eligibility?

March 7—Federal officials this week approved the third Medicaid waiver that requires work or other steps by beneficiaries but put off a decision on the key question of limiting eligibility.

By Rich Daly March 8, 2018

How One ACA Insurer Had Its Best Year in 2018

March 6—In a year when individual-market insurance enrollment dipped nationally, the dominant insurer in Florida had its largest enrollment yet.

By Rich Daly March 7, 2018
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