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.
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.
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.
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.
The ‘Narrow Network’ Trap—and How to Avoid It
Establishing protocols for checking eligibility and benefits for every patient is one way that physician practices can avoid the traps posed by narrow networks. Insurance eligibility is getting even more complicated. Since the advent
The Future of VACs: Valuation and Strategic Considerations
Recent changes to the Medicare Physician Fee Schedule may make it financially advantageous for vascular access centers operating under an extension-of-practice model to shift their operations to an ambulatory surgery center setting.
Debunking MACRA Myths: Hospitals’ Vital Role in Physician Success
Time is running out for physicians participating in the Merit-based Incentive Payment system to submit the minimum data required for 2017.
Azar: Time to Move Value-Based Payment Beyond ACOs, Bundles
March 5—The new leader of healthcare policy for the federal government says it’s time to advance value-based payment efforts beyond accountable care organizations (ACOs) and bundled payment initiatives.
340B Reporting Bill Draws Hospital Worry
March 5—Hospitals are concerned that new transparency legislation will leave the wrong impression about a federal discount drug program that’s come under fire from pharmaceutical companies.
Short-Term Limited Duration Insurance Proposed Rule
This document summarizes the proposed rule published by The Departments of Treasury, Labor, and Health and Human Services amending the definition of short term, limited duration (STLD) insurance for purposes of its exclusion from the definition of individual health insurance coverage.