PayerPayers Advise Caution, Request Delays on HHS-Proposed Marketplace Requirements
"If the ACA intended to fully commoditize coverage, it could have done so," noted one respondent regarding proposed marketplace standardization.
Clinical CareBundled Payment Program Reduced Surgery Costs By 50%
The payment model assesses surgical necessity; bundles payments for certain elective surgical procedures; ensures appropriate site of care and use...
Revenue CycleBundled Payment Program Yields Big Savings for Commercially Insured Patients
There was an average savings of $16,144 per procedure when the surgery was performed through the Carrum Health program.
Revenue CycleCMS Reminder: HCPCS Add-on Code G2211 is a Bundled Service
The application of this code will not result in additional payment for a billed E/M visit service.
InnovationRWJBarnabas Executive Views Social Determinants as Catalyst for Change
The coronavirus pandemic created challenges and opportunities for change as Paul Alexander, MD, MPH, took the reins as chief transformation...
FinanceMedicare Overpaid for Postoperative Care by $2.6B in 2018
Less than 40% of postoperative visits paid for by Medicare were provided following major surgical procedures.
InnovationEight More Hospitals Join PA's Rural Health Model
The Rural Health Model, the first of its kind, creates an alternative payment model that transitions hospitals from fee-for-service to...
Finance3 Great Revenue Cycle Exchange Ideas
"Charge segregation," empowering SBO reps, and demythologizing point-of-service collections were among the great ideas presented last week at the HealthLeaders...
Clinical CareInsurers Test New Way To Cut Maternity Care Costs: Bundling
A handful of insurers and state Medicaid programs are experimenting with bundled models, sometimes incorporating hospitals and other health providers.
Strategy7 Strategies for ACO Success
The report comes amid projections that Medicare spending will exceed $1.5 trillion by 2028, which is more than double the...
FinanceCMS Proposing Bundled Payment Model for Radiation Oncology
Participation would be mandatory for certain geographic areas during the model's projected five-year timeline.
Clinical CareHave Readmissions Penalties Jumped the Shark?
New research suggests that CMS may no longer be able to squeeze any significant savings from its Hospital Readmissions Reduction...