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  June 25, 2014 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Wellpoint Gives Voice to Physician Leaders

Christopher Cheney, Editor for HealthLeaders Media

A social media initiative gives future physician leaders a platform from which to share their ideas on healthcare in an effort to boost debate and engagement within and beyond the medical community. >>>

 

Editor's Picks

Beware the Reimbursement Gap

If a patient doesn't pay his health insurance premiums, the insurer doesn't have to pay the provider for care rendered during the grace period. That means that up to two months of provider services may not be reimbursed. >>>

Transitioning to Bundled Payments

Taking a more strategic approach to payer relationships may be the key to surviving new reimbursements models. >>>

Physicians Rail at Recertification Requirements

Medical doctors are facing revamped board recertification requirements that are "expensive, burdensome, and detract from the care of the patient," says David Fleming, president of the American College of Physicians. >>>

Where Value-Based Purchasing is Still Nascent

A recent conversation with a hospital president in Nebraska shows that it's not always payers who are forcing the value-based conversation. >>>

Senior Medicare Fraud Patrol Recovers $5.9M

A California beneficiary trained to spot fraud saw something on her Medicare summary notice and said something to her local fraud patrol organization, sparking a multi-year federal investigation and ending in jail time for fraudsters. >>>

Physicians Feel Reform's Tight Scrutiny

Thanks to healthcare reform, there are now more eyes on how doctors treat their patients and more opinions on how they should be treating them. But one physician leader says the pressure doesn't necessarily mean that doctors have to be on the defensive. >>>

HFMA ANI: Tackling Healthcare's Ever-Growing Complexity

Even though reimbursements remain heavily tilted to fee-for-service, healthcare organizations are making big mistakes if they aren't marrying clinical and financial metrics and engaging in data analytics, says HFMA's president. >>>

How Medica Revived Zombie Health Plans

Halfway through the PPACA open-enrollment period, health insurance carriers in more than two dozen states had only about six weeks to resurrect non-PPACA-compliant policies. Medica found a way to revive 81 "zombie," or transitional policies. >>>



Intelligence Report

Intelligence Report: The Clinical Strategy for Financial Health—Care Redesign & Standardization

This report reveals how Firelands Regional Medical Center, Kaleida Health, and UC Davis Medical Center are introducing new programs aimed at care redesign, care standardization, and driving waste out of healthcare delivery. Order Today >>>



News Headlines

House, Senate begin compromise talks on vets healthcare bill

The Miami Herald / Associated Press, June 25, 2014

VT to assess insurer reimbursements to independent physicians

Brattleboro Reformer, June 25, 2014

Obamacare impact on emergency rooms unclear

Sun Times, June 24, 2014

A reminder that not everyone loves more transparency for healthcare prices

The Washington Post, June 24, 2014

Bigger health companies: Good for Medicare, maybe not for others

The New York Times, June 24, 2014

IL hospitals facing Medicare penalties over infection rates

Chicago Tribune / Kaiser Health News, June 23, 2014

Medicare billing outliers often have disciplinary problems, too

ProPublica, June 23, 2014

Breaking down barriers to healthcare

The Boston Globe, June 23, 2014

Report: Ways and Means subpoenaed in Medicare leak probe

The Hill, June 20, 2014

More than half of Obamacare customers lacked coverage

Bloomberg, June 20, 2014



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Multimedia/Events

Webcast: Hospitals Developing Health Plans—Key Steps to Becoming a Provider-Payer

Date: July 16, 2014, 1:00–2:30 p.m. ET Health plan leaders from North Shore-LIJ and Sanford Health outline the strategic transition from provider to payer, and new opportunities for controlling costs, managing risk, and maximizing reimbursements. Register Today >>>




From HealthLeaders Magazine

New Goals, New Alliances

The historically adversarial relationship between providers and payers is shifting toward cautious cooperation as both sides recognize that they must implement structural and strategic changes to ensure their mutual survival. >>>

 

Transitioning to Bundled Payments

 

Preparing and Caring for Patients with Dementia



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