Claims Processing
In an education session Monday at HIMSS13 titled "How Hospitals Improve Their Bottom Line and Improve Relationships with Uninsureds," two people on the front lines showcased an innovative, IT-enabled approach to "transition from seeing these patients as a burden," and toward a way to better engage them in financing their care.
With the Affordable Care Act's (ACA) expansion of insurance coverage expected to increase the need for primary care services -- requiring an estimated additional 7,200 primary care providers -- 7 million Americans could likely face a primary care physician shortage after 2014.
The Department of Health and Human Services has published final rules for essential health benefits and several other policies that clarify rules on mental health benefits.
The Centers for Medicare & Medicaid Services (CMS) has proposed several dozen regulatory updates to Medicare Advantage and Part D prescription drug plans, covering cost sharing, minimum loss ratios, risk adjustment, payment methodologies and other policies.
Medicare patients can anticipate paying considerably less for their diabetes and other products starting in July when the Centers for Medicare & Medicaid Services expands its competitive bidding for durable medical equipment (DME) and mail-order program but the DME industry continues to point out problems with the program.
A new study is adding fuel to the debate over the value of copay offset cards, used to defer a patient's copayment for prescription medications.
The earlier hospitals begin to plan and strategize for how they will handle the healthcare environment once health insurance exchanges are operational, the better, said Purva Rawal, senior manager of health reform at Avalere Health, during a webinar Thursday.
We hear a great deal about healthcare consolidation today. The truth is, it has been happening in earnest for two to three years already, and it isn't showing any signs of slowing down.
On Wednesday, New York Attorney General Eric T. Schneiderman announced that his office recovered over $335 million for the state in 2012 that had been improperly claimed through fraud or abuse in the Medicaid system.
In a report released last week, the Commonwealth Fund Commission on a High Performance Health System describes a set of three healthcare policies that could slow health spending by $2 trillion over 10 years by focusing on the way public and private purchasers pay for healthcare, enhancing consumers' choices of higher-value care and streamlining administrative procedures.