Health information technology cognoscenti predict most large hospitals and health systems, physician groups and health plans can handle the numerous, complex and very specific new codes. Any cramps will appear later as providers' cash flows get hit by delayed reimbursements.
The possibility of a government shutdown Thursday could have a ripple effect on healthcare providers but mostly if the shutdown is prolonged. Congress is in an eleventh-hour race to pass a spending bill or risk a second government shutdown.
Voce Capital Management, a San Francisco-based hedge fund, has asked air ambulance company Air Methods Corp. to consider selling itself to a private equity firm and avoiding the transparency of being a public company.
Until recently, insurers and providers did not have good ways of measuring the cost-effectiveness of post-acute care providers, and patients lacked clarity on what to expect after they were discharged. NaviHealth is trying to change that.
Four years into Medicare's drive to cut the number of patients who land back in the hospital within a few weeks of leaving, only a quarter of more than 3,400 hospitals avoided penalties, contributing to skepticism about the program and the array of metrics used to evaluate healthcare quality.
Health insurance premiums on New York's state-run exchange will rise an average of 7.1% next year. But rates differ greatly by payer, plan type and region, highlighting the difficulties of relying on rough averages.
Some hospital system executives are citing booming insurer stock prices as a clear market signal that consolidation will give payers the upper hand in future price negotiations with hospitals and other providers. But insurers are not the only ones seeing strong results.
Patient engagement is a top priority for both health systems and health plans in population health management. So how can health systems and health plans increase patient engagement?
Christopher Dawes, president and CEO of Lucile Packard Children's Hospital at Stanford, a 300-bed hospital in Palo Alto, Calif., discusses the issues raised by Medicaid expansion, narrow-network health plans and high prescription drug costs. He spoke with Modern Healthcare reporter Bob Herman.
Biopharmaceutical companies have begun involving payers, physicians and patient advocacy groups in the early stages of drug development. The goal of partnering bottom line-driven drugmakers with frugal payers is to link the cost of care with patient health outcomes rather than the volume of...
The CMS has revealed reimbursement amounts to compensate health plans as part of the ACA's reinsurance program and some plans may be sorely disappointed.
The CMS is about to release a sweeping proposed rule that could fuel a major expansion of Medicaid managed long-term care for elderly and disabled beneficiaries.