Optimizing the Preauthorization Process
Senior healthcare provider and health plan leaders examine the difficulties associated with preauthorization and offer strategies for how stakeholders can collaborate to optimize the process.
The Future of Value
The move toward value remains a constant although the future of health care is uncertain.
Contemplating the Potential Impact of the AHCA
Understanding legislation proposed to repeal and replace the Affordable Care Act (ACA) is important, given that a bill to repeal and replace the ACA seems inevitable.
Maximizing Out-of-Network Payment for Patients with ACA Exchange Products
Hospitals should take steps to ensure the receive the full payment to which they are entitled for out-of-network patients enrolled in health plans purchased on the Affordable Care Act insurance exchange.
Four Strategies to Maximize Adult Immunization Quality and Financial Benefits
Jill Powelson describes how healthcare organizations can maximize revenue opportunities for immunizations.
Value-Based Payment—from a Different Perspective
Giesinger Health System has gained many advantages from offering its own, provider-sponsored health plan.
Assessing the Impact of Medicaid Expansion
Medicaid expansion reduced the amount of hospital charity care in participating states, while charity care remained almost unchanged in non-participating states during the same time period.
Building a Value Model for Population Health Management
A data-driven “value model” can help healthcare organizations plan the scale and pace of investments into population health management in preparation for value-based contracting.
Beyond the Medicare Annual Well Visit: Maximizing Revenue for Hospital-Owned Practices
Medicare-covered services may present a new source of revenue for hospital-owned physician practices.
The Fate of Value-Based Care with an ACA Repeal
The move to value-based care may not go forward under Republicans’ plan to repeal and replace the Affordable Care Act.