Medicaid, Drug Prices Could See Big Election Impacts
Nov. 7—On Tuesday, voters in three states approved expanding Medicaid eligibility to a total of more than 300,000 people.
Providers Should Keep Watch on Payer Discount Increases
A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.
Amid Headwinds, For-Profit Hospital Outlook Stays Stable
Oct. 24—The outlook among for-profit hospitals remains stable over the coming 18 months, according to Moody’s Investors Service.
Don’t Steer Away from Auto Accident Revenue Cycle Challenges
Brad Williams describes helpful strategies for recovering payments due based on patient involvement in auto accidents, which can be difficult to navigate but well worth pursuing.
How to Get Involved in CAQH CORE’s Work
CAQH CORE currently is forming groups to work on healthcare data standardization. Healthcare finance professionals are a core constituent and CAQH welcomes their participation.
Why Fee-For-Service Remains Prominent
Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.
How to Really Know Your Payment Rates
A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.
Are Employers Rethinking High-Deductible Plans?
Aug. 7—Employers that provide insurance for their workers are expressing an unusual degree of reluctance about high-deductible health plans (HDHPs).
Public Poll, Verma Reject Single-Payer
July 25—The administrator for the Centers for Medicare & Medicaid Services (CMS) said she is likely to reject an expected single-payer proposal from California. Her position echoed the sentiments of a national poll released this week.
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.