Reimbursement
The hospital claims that reimbursements for the drugs were determined by a payment model that is no longer valid.
This includes the biggest bang for the buck tasks such as prior authorization and complex claims, says Venkat Kavarthapu, CEO of Edifecs.
The state has seen some success in overhauling its provider payment structure in a push to advance value-based care.
The state has seen some success in overhauling its provider payment structure in a push to advance value-based care. Tom Borys and Abe Berman of the OneCare Vermont ACO discuss.
The baby boomer population, which has driven the growth of MA, is reaching its peak potential of profitability.
The only negative trend was a dramatic increase in the use of the Independent Dispute Resolution process.
AHIP says it is reviewing the "complex set" of proposals.
As the fixed-loss amount for HCO cases continues to rise, LTCHs are incurring greater and greater losses, group says.
The firm says hospitals must reinvest in strategic growth to stay on track financially in 2024.
AI adds a capability to identify when interventions are necessary and to get an idea of the health and needs of a population, says Matt Cybulsky, founder of Ionian Healthcare Consulting.