Reimbursement

Eleven Republican governors sent a letter to President Barack Obama Thursday requesting a meeting to discuss the details and costs associated with Medicaid expansion as outlined in the Affordable Care Act.

Bundled payment and payment reform in general are hot topics in healthcare circles, and will prove to be a challenge for many. Jay Sultan, thought leader for payment reform at TriZetto, a healthcare management solutions company, shared with Healthcare Finance News five key ideas for hospital leaders to consider in order to break barriers to successfully implement payment reform at their organizations.

Just as the final tally was coming in for state decisions on health insurance exchanges, the Department of Health and Human Services sent an HIX FAQ to all 50 governors, trying to explain aspects of exchanges that've puzzled some state lawmakers and insurance regulators for months.

Family premium costs for employer-sponsored health insurance have risen 62 percent between 2003 and 2011, according to an analysis by the Commonwealth Fund.

Consumer-directed health plans with high deductibles typically exempt recommended preventive care such as annual physicals or screening tests from the plan's deductible or require only a small copay as a way to ease financial barriers and encourage patients to seek care. However, many patients don't understand their plan benefits for preventative office care and tend to avoid visits altogether.

In what's been billed as one of the first commercial accountable care programs in Florida, Naples, Fla.-based NCH Healthcare System will team up with the state's Blue Cross and Blue Shield Company to participate in the Florida Blue Accountable Care Program.

HealthEdge, which develops software for payers, has acquired Click4Care, a firm that specializes in care management technology for health insurers. 

Use of prepayment edits saved Medicare at least $1.76 billion in fiscal year 2010, but a new study by the Government Accountability Office found that savings could have been greater had the edits been more widely used.

A diverse group of more than 350 healthcare, patient, veterans and business organizations on Tuesday urged Congressional leaders to reject any proposal to turn the Medicare Part D plan into one that resembles the rebates structure of Medicaid drug programs.

The U.S. Department of Health and Human Services' Office of the Inspector General (OIG) is investigating Minnesota's Medicaid managed care payment rates to HMOs between 2008 and 2009.