States and major insurance companies say they need more time to implement new rules meant to offer better coverage of mental-health and substance-abuse treatment to those in Medicaid managed-care plans. The implications are huge for a population that struggles to get care, especially for...
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.
A payment reform strategy offering consolidated billing codes and bundled cancer-care payments aims to “fundamentally restructure” the way cancer care is paid for in the U.S.
Dr. Stephen Grubbs has been named senior director of the new clinical affairs department of the American Society of Clinical Oncology in Alexandria, Va.
iVinci's CEO developed the technology after a year managing the revenue-cycle process at St. Luke's Health System in Boise. He told the system's executives they had to understand patients' payment patterns if they wanted to handle the rising tide of high-deductible plans.
Last week's Supreme Court 5-4 decision sharply limiting private healthcare providers' right to sue state Medicaid agencies over low payment rates could reduce low-income Americans' access to care.
As an industry, we have arrived at a moment when even fee-for-service stalwarts see the handwriting on the wall: The current reimbursement system is not sustainable. We must find better ways to align the interests of patients, payers and providers.
Data Points for the week of March 23, 2015, covered the following topics: Out-of-pocket costs for patients, deductibles and medical debt
Physicians need support and guidance from the federal government and from payers as they deal with the challenges of transitioning away from fee-for-service, according to a report released Thursday.
In a lawsuit that will go before a state judge this week, eight not-for-profit hospitals in western Pennsylvania will argue that health insurer Highmark improperly trimmed Medicare Advantage payments by 2% last year following federal budget cuts.
Utah Gov. Gary Herbert's trimmed-down plan for expanding Medicaid appears to have hit a dead end at the state Capitol.
The CMS has proposed increasing health insurers' Medicare Advantage payment rates by 1.05% for 2016, a move that kicks off a 45-day dogfight in Washington before the rates are cemented.