Reimbursement
Trying to wean themselves off fee-for-service reimbursement, some health systems may be taking a non-committal strategy, dipping their toes in the water before deciding if they want to learn to swim. Insurers should be looking for more than that, if they can offer the right expertise.
Last week the HHS Office of Inspector General and the Centers for Medicare & Medicaid Services published a joint notice continuing the effectiveness of fraud and abuse law waivers granted in 2011 in connection with the Medicare Shared Savings Program.
Like many other industries, from manufacturing to retail, healthcare is looking to use information technology to transform and automate financial payments. Providers, though, have a lot of old and new choices.
Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don't include hospital benefits. Now the administration is concerned too.
Passing a key corporate milestone, UnitedHealth Group is on track to have a banner year, while trying to reshape large swaths of American healthcare.
Rising interest rates and regulatory oversight will be the top challenges confronting the senior care industry over the next year, according to a new survey of housing and care providers. But industry leaders feel good about a stronger business performance outlook.
This week CMS launched an ACO Investment Model, which will provide up to $114 million in upfront investments, to up to 75 Medicare Shared Savings Program ACOs. The program aims to help ACOs succeed in the MSSP by providing upfront capital to cover startup and ongoing infrastructure costs.
Where time equals brain in preventing death, disability and millions of dollars in spending, insurers and providers have a huge opportunity to try an approach that can pay for itself.
Insurers are trying to use a new model to improve treatment in costly, difficult chronic diseases like Crohn's, and rationalize reimbursement.
As a microcosm of American health insurance markets, with both old and new regulations and business trends, one corner of the country offers a window into the future.