A reference pricing strategy, in which an employer agrees to pay a certain amount for a procedure and anything above that amount is the employee's responsibility, cut the price of hip and knee replacement surgeries by 19% in a one-year trial.
While health insurers intend to participate in public health insurance exchanges, the general strategy is to wait and see. Payers are looking to private exchanges and even proprietary exchanges to enable them to more efficiently serve their customers
On an earnings call, the chief executive officer of CHS offers details on the forthcoming merger with Health Management Associates. Described as a "revenue opportunity," the deal will form the largest for-profit hospital system in the U.S.
Health Management Associates' largest shareholder says it intends to proceed with plans to replace the sitting HMA board, hours after Community Health Systems said it would acquire the embattled hospital chain.
Financial incentives for self-referring providers "were likely a major factor driving" an increase in referrals and millions of dollars in unnecessary Medicare costs, a Government Accounting Office report finds.
Two prominent media reports critical of the American Medical Association's influence over payment rates for services on the Medicare physician fee schedule coincide with a renewed legislative push to diminish the group's power over pricing.
So-called "doc-fix" legislation that would replace the sustainable growth rate formula with a system that rewards physicians for delivering quality care could be up for a full committee vote this week.