Reimbursement

Prior authorizations (PAs) are achieving one of the goals health plans sought – lowering drug costs. Although the process has become a growing burden for provides, payers and members, the right technology can resolve these issues.

Providers earned almost $321 million in shared savings by improving quality and reducing costs in the program's first three years.

The AMA and other plaintiffs contend the insurer significantly underpaid claims and put patients at risk of balance billing.

Key funding programs are set to expire at the end of the month, hospital group says.

CMS should make advance payments available to all ACOs working to achieve health equity, their letter says.

Across all practices, the median revenue amount from value-based contracts was $30,922 per provider.

In July 2022, overall prices grew 8.5% from the previous year, but prices for medical care increased only 4.8%.

Currently, a nurse or physician is required to be physically present in the home for providers to be reimbursed by Medicare.

The AHA wants Congress to halt Medicare payment cuts and extend or make permanent certain waivers, among other requests.

One organization has engaged legal counsel, saying it hopes deficiencies identified will be corrected in the final rule.