Reimbursement
Aetna has found itself in the odd position of being fined for covering something some members wanted, while not being fully up to speed covering another condition.
The Advisory Board revenue cycle head Ed Hock says punting on ICD-10 until the new code set is ready robs healthcare providers of the benefits of the Oct. 1 changeover.
“Not all readmissions can or should be prevented; indeed, some are planned as part of sound clinical care,” AHA says.
Participants in the program are expected to scale their value-based payments to 30 percent by 2016 and 50 percent by 2018.
Under the provision, CMS could continue to use Medicare Administrative Contractors to "probe and educate" providers on their likely compliance with the two-midnight rule.
Bill calls for stiffer fines for tax delinquent Medicare service providers, keeping reimbursement for acute care providers to 1 percent and by upping premiums for wealthier Medicare beneficiaries.
Staring down the sometimes troubled and opaque past of medical devices, and upward trend in spending, one national insurer is trying to build momentum for a universal way to compare and track outcomes.
This tax season, for the first time since the health law passed five years ago, consumers are facing its financial consequences. The worst may be yet to come.
Silicon Valley is coming for the employer sponsored health insurance business, trying to raise the bar on group health benefits and "democratize" self-funding.
The state that put itself on the vanguard of health reform only to struggle under the weight of its own ambition is now has an ultimatum for fixing its public insurance exchange.