News
With government fraud investigations and federal whistleblower cases on the rise, healthcare providers will step up their compliance efforts in 2012 to avoid being the target of scrutiny.
An amicus brief filed with the United States Supreme Court by America's Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association contends that certain market reforms contained in the Patient Protection and Affordable Care Act are directly linked and must also be severed from the law if the justices find the individual insurance mandate unconstitutional.
Jeff Rideout, Chief Medical Officer, TriZetto Group, spoke recently with Healthcare Finance News Senior Editor Chris Anderson about how data will play a part in redesigning the healthcare landscape and the readiness of both payers and providers to collaborate on these changes.
The Supreme Judicial Court of Massachusetts in early January struck down a state law in effect since 2009 that barred some legal immigrants residing in the state from receiving subsidized health insurance coverage.
As healthcare reform pushes the industry toward accountable care organization models and payment reform, the American Academy of Family Physicians (AAFP) is hoping to offer its members a tool that will allow them to bring in revenue and improve the health of their patients.
As reimbursement rates have declined and more employers are offering their employees high-deductible health plans, doctors’ offices are more dependent on often less reliable payment directly from patients. In 2012, strategies for handling billing those patients will be a focus of doctors’ offices experts say.
As the trend of doctors leaving private practice to join hospitals and health systems continues, the pressure is on those doctors who aren’t leaving private practice. Marketing can help dial the pressure back.
The Medicare Payment Advisory Commission (MedPAC) recommended in early January that Congress provide an update of 1.0 percent for fiscal year 2013 inpatient and outpatient hospital payments and reduce Medicare payment rates for non-emergent hospital visits to be the same as payments made for equivalent services delivered at doctor’s offices.
If the economy picks up in 2012, hospitals may find themselves scrambling to hang onto key employees.
A new study on the cost of hospital readmissions finds that about 1 in 12 adults discharged from a hospital is readmitted within 30 days, adding $16 billion to the cost of healthcare in the United States, and, according to analysts, it underscores the need for a comprehensive approach to reforms.