CMS ISSUES SURPRISE BILLING INTERIM FINAL RULE. PAYERS PRAISE! HOSPITALS HOWL!
The rule lays out how payers and providers will resolve billing disputes under the No Surprises Act.
2022 MEDICARE ADVANTAGE PLAN OVERVIEW, PART ONE: COSTS AND LEADING CARRIERS
"Medicare consumers overall ... crave stability of benefits and a hassle-free experience that gets them the care and coverage they need at a price they can afford," says one health plan executive.
DIGNITY HEALTH TAKES CONTRACT SPAT WITH ANTHEM PUBLIC
The health system is urging its customers to "take action" and "call Anthem at the number on the back of your insurance card and urge them to work with Dignity Health doctors and hospitals on a new agreement."
ANTHEM, UNITEDHEALTHCARE MA PLANS SANCTIONED FOR MISSING MLR THRESHOLD
When a Medicare Advantage plan fails for three straight years to meet the 85% threshold, CMS must suspend them from accepting new enrollees for the next contract year.
WHY THE FEE-FOR-SERVICE CHASSIS CONTINUES TO DOMINATE VALUE-BASED PURCHASING AND WHAT TO DO ABOUT IT
The FFS claims submission process is still the primary means for capturing the broader encounter data needed for VBP analysis and payment.
HUMANA ACQUIRES ONE HOMECARE SOLUTIONS
The acquisition marks another step in Humana's strategic initiative to further develop the organization's value-based home healthcare offerings.
ALTERNATIVE DATA PAIRED WITH SOCIAL DETERMINANTS HELP REDRAW PATIENT HEALTH OUTCOMES
One payer hopes to make healthcare more equitable by using alternative data.
2022 MEDICARE ADVANTAGE PLAN OVERVIEW, PART TWO: PORTFOLIO STRATEGY AND LEADING CARRIERS
Portfolios are designed to "make care more affordable, accessible and convenient," in the words of one executive.
HHS UNVEILS INTERIM FINAL RULE FOR SURPRISE BILLING
The Requirements Related to Surprise Billing; Part I , set to take effect on January 1, 2022, is the first in a series of rules to protect patients from healthcare-related financial hardships.
OSCAR VP OF GROWTH DETAILS CIGNA PARTNERSHIP
Louis DeStefano, head of small group business and senior vice president of growth at Oscar, said the partnership provides both payers with the opportunity to combine their respective strengths to benefit consumers.