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.
Payers' efforts to drive down hospital prices may be succeeding. Prices that private and public health insurers paid to acute-care hospitals declined in January, compared with the same month a year ago, the first time they have dropped since the federal government began collecting these data.
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.
Sutter Health, a California not-for-profit 24-hospital system, and insurer Blue Shield of California have come to an agreement after a monthlong feud over price increases and new contract terms.
A large payer and health system in California are embroiled in a bitter feud over expired contract terms, the type of fight all too common in the fee-for-service world. Value-based pay promises to align providers and payers in the pursuit of efficient care, but they're likely to keep fighting.
I am a strong advocate for providing quality care but am disappointed when my organization does follow-up on current Medicare HCAHPS. Often responses are given by people not involved in the patient's care (the patient or their spokesperson).
Sorting through the shards of Vermont's discarded single-payer health insurance scheme reveals the plan was undone by its generosity toward patients, hospitals and physicians, not its core assumptions.
Telehealth startup American Well announced a $80 million funding round Tuesday, capping a big year in funding for telehealth startups.