Fierce Healthcare

FEBRUARY 5, 2024

Humana reaffirmed its guidance in the face of likely cuts in Medicare Advantage payment rates for 2025, despite saying the proposed decrease was higher than it expected. Humana reaffirmed its guidance in the face of likely cuts in Medicare Advantage payment rates for 2025, despite saying the proposed decrease was higher than it expected.

Medicare 244

Medicare 244

Health Care Dive

JUNE 16, 2023

The group that advises Congress on Medicare policy also suggested more closely setting payment rates across outpatient facilities for some services, which hospital lobbyists oppose.

Medicare 293

Medicare Hospitals 293

Fierce Healthcare

FEBRUARY 21, 2024

Medicaid disproportionate share hospital (DSH) payments are being cut by $8 billion annually during the current and next four federal fiscal years under a new Centers for Medicare and Medicaid Serv | Published Tuesday and set to go into effect in two months, the final rule limits the calculation of a hospitals Medicaid shortfall to beneficiaries with (..)

Medicaid 258

Medicaid Hospitals Medicare 258

Health Care Dive

APRIL 27, 2023

Political will appears to be rising to equalize Medicare payments to hospitals and doctor’s offices for certain low-acuity services, according to lawmaker comments during a Wednesday hearing.

Doctors 321

Doctors Medicare Hospitals 321

Fierce Healthcare

NOVEMBER 5, 2023

Family physicians utilizing value-based payment (VBP) models reported burnout relief in a new study from EHR com | The study found that higher capitation rates combined with greater overall percentage of revenue from capitation resulted in the biggest reduction in physician burnout.

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Health Care Dive

SEPTEMBER 20, 2023

A new payment model and reimbursement cuts are straining home health agencies, but more data may be needed to fully evaluate the model, advocates and researchers said during a Senate finance committee hearing.

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Fierce Healthcare

JULY 14, 2023

The Center for Medicare and Medicaid Innovation (CMMI) has released a request for information to design a future episode-based payment model. | It is expected that a new episode-based payment model would be implemented no earlier than 2026, CMMI said.

Medicaid 246

Medicaid Medicare 246

Fierce Healthcare

NOVEMBER 2, 2023

The Centers for Medicare & Medicaid Services has dropped the final rule to remedy the invalidated 340B-acquired drug payment policy for calendar years 2018 to 2022. |

Hospitals 293

Hospitals Medicare Medicaid 293

Fierce Healthcare

OCTOBER 18, 2023

Healthcare payment software maker Waystar filed for an initial public offering, signaling a potential end to the dry spell in the health tech IPO market. Healthcare payment software maker Waystar filed for an initial public offering, signaling a potential end to the dry spell in the health tech IPO market.

Healthcare 273

Healthcare 273

Health Care Dive

JANUARY 30, 2023

With the right payment integrity approach and finely tuned focus, payers will find the exceptional service execution required to thrive in today’s environment.

Integration 246

Integration 246

Healthcare ECONOMIST

APRIL 23, 2024

While CMS has a target of getting 100% of Medicare beneficiaries into value-based payment (VBP) programs–such as accountable care organizations–by the end of the decade, implementing VBP in practice will be challenging. Providers forego certain revenue for uncertain ‘bonus’ payments.

Accountable Care 73

Accountable Care Medicare Accountability Hospitals 73

Fierce Healthcare

APRIL 22, 2024

The Centers for Medicare & Medicaid Services is hoping to improve Medicaid enrollees’ access to care through a final rule that better compensates caregiving roles. | CMS released a series of final rules Monday, including Medicaid access regulations that some groups worry will cause providers to close.

Medicaid 306

Medicaid Home Care Regulations Medicare 306

Health Care Dive

JULY 7, 2023

The National Association for Home Care and Hospice said regulators used “an illogical and invalid methodology” in a new payment model.

Regulations 261

Regulations Home Care 261

Fierce Healthcare

DECEMBER 15, 2021

LAN survey: 40% of health payments tied to alternative payment models in 2020. Wed, 12/15/2021 - 15:21.

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293

Fierce Healthcare

JUNE 16, 2023

A pair of key panels advising Congress on Medicare and Medicaid policy recommended lawmakers adopt contentious site-neutral payment for certain ambulatory services and amend the Social Security Act | The congressional advisory panels backed site-neutral payments for certain ambulatory services and called for amendments to secure uncompensated care (..)

Hospitals 246

Hospitals Medicaid Medicare 246

Health Care Dive

APRIL 8, 2024

The final rule issued Thursday prevents insurers from paying brokers additional fees for steering beneficiaries to their plans.

Medicare 274

Medicare Prevention 274

Fierce Healthcare

AUGUST 16, 2023

The collapse of insurtechs Bright Health and Friday Health Plans might mean that legacy health insurers in states where Bright and Friday operated will not receive over $1 billion worth of expected | Florida Blue, HCSC, Medica, Centene and Molina Healthcare might also suffer because of the financial troubles experienced by Bright Health and Friday (..)

Healthcare 246

Healthcare 246

Health Care Dive

OCTOBER 17, 2022

Explore potential consequences and remedies for 3 compliance risks in the healthcare payments space.

Healthcare 274

Healthcare 274

Fierce Healthcare

APRIL 5, 2023

Medicaid payment for mental health services shortchanges psychiatrists in many states: study fdiamond Wed, 04/05/2023 - 15:21

Medicaid 293

Medicaid 293

Health Care Dive

MARCH 17, 2022

"At a minimum, Congress must establish a stable, annual Medicare physician payment update that keeps pace with inflation and practice costs," AMA wrote in its letter.

Medicare 324

Medicare 324

Fierce Healthcare

JANUARY 3, 2023

Physician group practices struggle with bundled payments: study. Tue, 01/03/2023 - 14:29.

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283

HIT Consultant

JANUARY 9, 2024

Factors such as decentralized clinical trials, inflation and site attrition contribute to inconsistencies and financial confusion, especially with outdated payment solutions. To address these persistent challenges, sponsors can leverage modern clinical trial payment solutions. Jim DiCesare, Sr.

Accountability 83

Accountability Integration Regulations Prevention 83

Health Care Dive

MARCH 18, 2024

The relief comes as 94% of hospitals reported financial impact from the outage, according to a survey from the American Hospital Association.

Medicaid 305

Medicaid Hospitals 305

Fierce Healthcare

DECEMBER 13, 2022

Value-based payment system shortchanges PCPs, says study. Tue, 12/13/2022 - 14:39.

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284

Home Health Care

APRIL 12, 2024

Payment denials can be costly and time consuming for home health providers, and they’re often self-inflicted. The post How Home Health Providers Can Avoid Payment Denials appeared first on Home Health Care News. They don’t show me that they follow the rules.”

Medicare 105

Medicare Nursing 105

Fierce Healthcare

APRIL 20, 2023

Mark Cuban Cost Plus Drugs taps RevSpring for pharmacy payment tech agliadkovskaya Thu, 04/20/2023 - 17:41

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274

Health Care Dive

SEPTEMBER 7, 2022

Multiple groups representing doctors oppose Medicare payment reductions at a time when physician practices face escalating costs.

Prevention 278

Prevention Doctors Medicare 278

p3care

MAY 22, 2023

Despite all the issues practice may face, one of the most common is capturing payments from payers. Luckily, modern technology has come up with appealing solutions for effective payment collection. In this blog, we will jump into the details of how to assure easy payment collections from patients and their insurance payers.

Regulations 130

Regulations Patient Experience Healthcare 130

Fierce Healthcare

MAY 5, 2023

OIG flags $580M in improper Medicare payments for psychotherapy, with the bulk billed for telehealth services aburky Fri, 05/05/2023 - 15:03

Medicare 293

Medicare 293

Fierce Healthcare

APRIL 13, 2023

House oversight committee seeks answers on hospitals' COVID relief funds, improper Medicaid payments dmuoio Thu, 04/13/2023 - 13:59

Medicaid 260

Medicaid Hospitals 260

Fierce Healthcare

APRIL 26, 2023

OIG audit reveals lack of data sharing led to $128M in duplicate payments by Medicare, VA aburky Wed, 04/26/2023 - 13:01

Medicare 307

Medicare 307

Fierce Healthcare

APRIL 5, 2023

Study: Cuts to Medicare Advantage payments may have modest impact on seniors' benefits rking Wed, 04/05/2023 - 16:35

Medicare 274

Medicare 274

Healthcare It News

OCTOBER 19, 2021

The health claims payment process in its current incarnation can take days – leaving providers wondering when they'll be paid for services, and members wondering how much their medical care will cost. WHY IT MATTERS.

Integration 332

Integration Healthcare 332

Fierce Healthcare

APRIL 26, 2023

Payers reduce admin costs by going back to basics with payment integrity jpiatt Wed, 04/26/2023 - 16:09

Integration 256

Integration 256

Fierce Healthcare

JANUARY 18, 2023

Providers' price hikes push patients to defer care, rely on payment plans, surveys say. Wed, 01/18/2023 - 12:15.

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299

Health Care Dive

JUNE 27, 2022

The highest court upheld HHS' method of calculating Medicare payments to hospitals serving a high proportion of low-income patients, rebutting hospitals’ efforts to recoup potentially billions of dollars from the program.

Medicare 274

Medicare Hospitals 274

Fierce Healthcare

MARCH 1, 2023

BCBSA: Broader site-neutral payment policies would save $471B over 10 years dmuoio Wed, 03/01/2023 - 14:20

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