Reimbursement

The Medical Group Management Association published research Thursday that suggests overall readiness of the industry to meet the Oct. 1, 2014, ICD-10 compliance deadline continues to be a concern.

In a world where traditional claims management practices no longer work, health plans must embrace new strategies to compete in a changing market, said experts Wednesday at the 2013 AHIP Institute.

In a world where traditional claims management practices no longer work, health plans must embrace new strategies to compete in a changing market, said experts Wednesday at the 2013 AHIP Institute.

With many of the moving parts needed to establish health insurance exchanges now fitting into place, the exchanges are now directing their attention toward consumer engagement and outreach said a panel of HIX executives Wednesday at the AHIP Institute Exchange Conference in Las Vegas.

With just 111 days left for health plans to be ready when health insurance exchanges or marketplaces open for enrollment Oct. 1, Health plans need to update technology, establish edge servers, new layers of enrollment and eligibility, connect with exchanges and the federal facilitated marketplace exchange (FFE).

As employers and individuals seek ways to squeeze more value out of their healthcare dollars, their demand for solid pricing and quality data is growing. Bob Kocher, a partner at venture capital firm Venrock and a former special assistant to the president for healthcare and economic policy in the Obama administration, will detail the path toward better pricing and quality data on Wednesday, June 19, at the Healthcare Financial Management Association's ANI 2013 in Orlando, Fla.

Safety Net Hospitals for Pharmaceutical Access (SNHPA), the group that represents hospitals in the federal 340B discount drug program, recently asked pharmaceutical manufacturer Amgen to withdraw its new policy that all 340B purchases of the company's drug Neulasta be made exclusively through specialty distribution channels.

As the healthcare industry transforms from a volume-based to a value-based payment system, it helps to learn from other organizations' experiences. Attendees of the June 19 education session, Operationalizing Value-Based Purchasing, at the Healthcare Financial Management Association's ANI 2013 next week in Orlando, Fla., will get the inside scoop from Barnabas Health's experience.

CareFirst BlueCross BlueShield reported last week that the second year (2012) of its patient-centered medical home (PCMH) program yielded cost savings of $98 million for 1 million members covered by the effort.

CareFirst BlueCross BlueShield reported on June 6 that the second year (2012) of its patient-centered medical home (PCMH) program yielded cost savings of $98 million for 1 million members covered by the effort.