Healthcare Finance Staff

A new report by the Health Research Institute of PricewaterhouseCoopers says the transformation from fee-for-service to value-based reimbursement will take longer than the ambitious timeline announced in January by Health and Human Services Secretary Sylvia Burwell.

Horizon Blue Cross Blue Shield of New Jersey's new ONMIA health alliance is under scrutiny from legislators in the state who want to delay the plan's rollout amid questions of how hospitals were chosen for the Tier 1 network.

While payer-provider collaboration has long been important, new trends in managing population health data is strengthening that relationship as never before, according to MedeAnalytics CEO Andy Hurd, and in many ways it's changing how providers think.

"Severe and unexpected cuts" to Medicaid payments in the Connecticut budget have stalled talks of a joint venture between Hartford HealthCare and Day Kimball Healthcare, according to Hartford HealthCare.

Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America's Health Insurance Plans.

Chronically ill people enrolled in individual health plans sold on the Affordable Care Act insurance exchanges pay on average twice as much out-of-pocket for prescription drugs each year than people covered through their workplace, according to a study published Monday in the Health Affairs journal.

While the Supreme Court decision in King v. Burwell that cleared subsidized health insurance premiums under the Affordable Care Act removed a lot of uncertainty from hospital finance, little has changed when it comes to hospitals' access to debt. But that may change.

On Thursday, providers dealt with system issues, which will be followed by productivity issues and then payment issues, according to healthcare insiders.

Healthcare Finance spent the bulk of Thursday's rollout monitoring the buzz, speaking with experts and reporting on any issues that may have arrived. While the true effects of the change will be felt in the coming weeks when claims are processed, bills delivered and accounts receivable wane, we have a few observations to share.

Insurance companies will pay $362 million to the federal government's shared risk program beginning this November for 2014 participation, but will be short $2.5 billion in payments that they hoped to receive from the federal government, the Department of Health and Human Services announced on Thursday.