Where healthcare challenges find solutions

Payment

As providers and the government try to lower healthcare costs, much of the action rests on lower reimbursement. Meanwhile, patients increasingly are reaching into their own pockets to cover their healthcare costs. They want price transparency and convenient ways to pay their bills, and providers want to maintain healthy margins. Read more about how payment innovations affect the industry.

Phase in DSH hospital cuts, overhaul policy, Medicaid panel advises

Phase in DSH hospital cuts, overhaul policy, Medicaid panel advises

The advisory panel will recommend that Congress slowly phase in disproportionate-share hospital cuts, due to start in October, but will not suggest that lawmakers continue delaying them. »

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Providers are still hitting snags in revenue-cycle optimization

Providers are still hitting snags in revenue-cycle optimization

More than half of executives surveyed said that new EHR functions haven't produced the expected gains in their organization's revenue-cycle performance.

Wage index reform could buoy rural hospitals

Wage index reform could buoy rural hospitals

HHS' Office of Inspector General has proposed changing the wage index in a new report that found the current system has led to millions in improper hospital payments, often acutely impacting rural providers.

Medicare considers passing pharmacy rebates to Part D patients

Medicare considers passing pharmacy rebates to Part D patients

In a sweeping new proposal focused on Medicare Advantage and Medicare Part D, the CMS is considering a policy to cut off pharmacy profits through price concessions and give Medicare Part D plans more power to negotiate protected class drug prices.

Nearly all MIPS clinicians score bonuses for year 1

Nearly all MIPS clinicians score bonuses for year 1

Of the more than 1 million eligible clinicians who participated in MIPS in 2017, 93% will receive a bonus on each of their Medicare Part B claims beginning Jan. 1. About 5% of clinicians will receive a penalty as high as 4% on their claims.

Encouraging patients to shop around amid high healthcare prices

Encouraging patients to shop around amid high healthcare prices

By offering incentives to patients, Vitals saves money for them, their employers and their health plans.

Medicaid expansion on the prairie: Nebraska's ballot initiative heads to the polls

Medicaid expansion on the prairie: Nebraska's ballot initiative heads to the polls

Four years into Obamacare, the majority of Nebraska voters support Medicaid expansion, a key measure on their midterm ballot. But even pro-expansion hospitals are taking a cautious view of how much it will impact the rural bottom line.

Dialysis cos. dole out more than $100M to beat Calif. ballot measure

Dialysis cos. dole out more than $100M to beat Calif. ballot measure

With just a few weeks to go until November's elections, the dialysis industry has raised more than $105 million to defeat a ballot measure that would cap their profits at 15% of direct patient-care costs.

ACOs to stay in shared-savings program despite downside risk

ACOs to stay in shared-savings program despite downside risk

Nearly half of accountable care organizations surveyed said they now intend to stay in the Medicare Shared Savings Program even though they could be facing downside risk soon, a change of heart from previous surveys.

Tenet, Trinity among the 1,300 joining latest bundled-pay model

Tenet, Trinity among the 1,300 joining latest bundled-pay model

About 1,300 providers, including 832 hospitals, have joined the Bundled Payment for Care Improvement Advanced alternative pay model. Providers will get a fixed price for an episode of care and be at risk for up to 20% of costs if they exceed a target.

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