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With the threat of significant reimbursement losses, hospitals and health systems are feeling the pressure of getting the transition to ICD-10 right.

Bundled payment and payment reform in general are hot topics in healthcare circles, and will prove to be a challenge for many. Jay Sultan, thought leader for payment reform at TriZetto, a healthcare management solutions company, shared with Healthcare Finance News five key ideas for hospital leaders to consider in order to break barriers to successfully implement payment reform at their organizations.

Consumer-directed health plans with high deductibles typically exempt recommended preventive care such as annual physicals or screening tests from the plan's deductible or require only a small copay as a way to ease financial barriers and encourage patients to seek care. However, many patients don't understand their plan benefits for preventative office care and tend to avoid visits altogether.

Last week New York Attorney General Eric T. Schneiderman announced a $3.1 million settlement with Excellus BlueCross BlueShield requiring the insurer to refund 12,000 plan members who overpaid their healthcare providers as a result of the company's improper accounting of deductibles.

BayCare Health System in Clearwater, Fla., has agreed to pay over $10.1 million to the federal government to resolve allegations that the health system violated the False Claims Act announced the U.S. Justice Department (DOJ) last week.

In an effort to control costs and get people covered by health insurance, the Affordable Care Act offers a number of options for covering low-income people. Among those options is the Basic Health Program, which some say will save money and others say will kill health insurance exchanges.

The U.S. Department of Health and Human Services (HHS) will need to place a lot of emphasis on implementing the Affordable Care Act (ACA) in the coming year, according to the Office of Inspector General's (OIG) annual summary of management and performance challenges facing the agency, released this week.

A recent New England Journal of Medicine (NEJM) study points to a new pilot program that offers payment models that may encourage hospitals to better coordinate transitions of care, resulting in fewer readmissions.

Following the devastation of post-tropical storm Sandy last week, the Centers for Medicare & Medicaid Services (CMS) issued blanket waivers of particular requirements that include all hospitals, skilled nursing facilities, home health agencies, hospice and end-stage renal disease facilities in the areas of New York and New Jersey that were strongly affected by the storm.

According to a new report from the National Association of Public Hospitals and Health Systems (NAPH), hospitals could possibly face a $53.3 billion increase in uncompensated care costs by 2019 if states forgo expanding their Medicaid programs as part of the Affordable Care Act (ACA).