Reimbursement

Community Health Systems has reduced its second quarter earnings forecast and announced it has received another subpoena related to an ongoing Department of Justice investigation into the hospital operator's admissions practices.

Many insurance brokers have a dismal view of their industry's future viability, as economic trends and health reform appear to reduce their demand, a survey by Aflac has found.

Leaders from the Centers for Medicare & Medicaid Services and the Internal Revenue Service said at an occasionally fractious congressional hearing that the federal data hub will be mostly, if not fully, functioning by October, supporting information sharing for insurance and Medicaid applications.

One would think, given the title of the CMS press release, "Pioneer Accountable Care Organizations succeed in improving care, lowering costs," that the first year of the advanced ACO program was an across-the-board roaring success. But upon closer examination, the report card would appear to be rather checkered.

An new national survey shows that, despite the one-year delay in ICD-10 compliance, many healthcare providers do not understand the value of the medical diagnostic codes that will be used beginning Oct. 1, 2014.

Medicare-covered physician self-referrals for anatomic pathology services -- diagnoses of human tissue -- more than doubled between 2004 and 2010, although new reimbursement policies may be stemming the tide, according to a new Government Accountability Office report.

Despite the one-year delay in ICD-10 compliance, many healthcare providers still do not understand the value of the new medical diagnostic codes that will be used beginning Oct. 1, 2014, according to a new survey from eHealth Initiative.

From the financial pangs at the pointy ends of the Affordable Care Act (ACA) to the frustrations and economic hardships courtesy of health information technology (HIT), a new physician outlook survey reveals the top challenges and concerns of physicians today.

One would think, given the title of the CMS press release, "Pioneer Accountable Care Organizations succeed in improving care, lowering costs," that the first year of the advanced ACO program was an across-the-board roaring success. But upon closer examination, the report card would appear to be rather checkered.

To remain competitive in a value-based care environment, health plans and ACO population managers must have visibility across a wide variety of care delivery settings. And, to effectively provide care for large populations, reduce the cost of that care and appropriately manage the risk associated with those patients, information must be captured from all caregivers, including ancillary providers such as rehabilitation specialists and mental health practitioners.