Accounting & Financial Management
Commercial insurers inaccurately process about 20 percent of claims filed by medical practices. It's an industry standard that has weathered the test of time -- though not in a good way.
Significant inpatient pricing variation between hospitals in the state of Washington is "putting some consumers at financial risk," according to a recent study by the Washington Health Alliance. But the state's hospitals are questioning the report's conclusions, claiming that price variation should not be surprising.
Variations on traditional group health insurance via insurer-administered self-funding remain the norm for many large employers. But some health systems are considering alternatives in the face of high costs, new regulations and demand for more choice.
The Centers for Medicare & Medicaid Services recent 10-year projection of national health expenditures includes retail spending on prescription drugs, but a more complete picture of pharma spending would include the nonretail segment.
With an improving fiscal climate, some states are paying their Medicaid providers more. More states are increasing fees to specialists, nursing homes and managed care organizations, but 31 states were cutting or freezing Medicaid hospital rates, compared to 19 that were increasing them.
Most hospitals fall well short of their cost reduction targets, in part because the ability of chief financial officers to meaningfully impact how operational and clinical leaders approach the issue is limited.
Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.
When a healthcare provider's data resides on someone else's servers, plenty can go wrong. And HIPAA isn't necessarily the worst of it. Experts offer contracting advice to help head off financial and legal disputes between vendors and providers.
A new report by the Virginia Hospital and Healthcare Association paints a grim picture of the daunting financial challenges facing hospitals and other healthcare organizations in that state.
New research suggests that socioeconomic factors can account for most of the geographical variation in Medicare spending. As a result, larger socio-demographic issues must be considered when assessing the quality of care offered by healthcare providers.