News

What is the secret to improved financial performance for hospitals in the age of healthcare reform? Understand and manage the convergence of quality, outcomes, patient experience, reimbursements and costs. And there’s no better place to start than with the hospital’s number one expense – the operating room.

With no comprehensive program designed to provide long-term care insurance, a panel of experts who convened in March agreed that comprehensive reform has about a five-year window for implementation in order to sufficiently meet the needs of baby boomers.

While the Great Recession has ended, it’s anything but back to business-as-usual for strategic and financial planners in the healthcare industry. The Affordable Care Act and the shift from the traditional fee-for-service payment system to an innovative fee-for-value system is seeing to that.

One of the business pain points for physicians is collecting payments from patients for their services, which often involves lots of customer service call time on the phone. An online payment platform for healthcare, called Money2, from Citi aims to make that process easier, more efficient and consumer-friendly, according to those involved with the tool.

By now, it is no surprise which states have said they won’t expand Medicaid as outlined under the Affordable Care Act. And while there are still a handful of states on the fence, it’s a given that states like Texas, Louisiana, Mississippi and Georgia, among others, were not going to budge.

Hospitals in states that don’t expand their Medicaid program as outlined under the Affordable Care Act are facing significant revenue reductions due to regulations that will reduce some Medicare and Medicaid payments in 2014, measures that were written into the law to help pay for the expansion of the insurance program for the poor.

On April 1, Highmark Inc. unveiled a group health plan aimed at larger employers and self-insured businesses that provides incentives for members to use providers that exhibit higher quality outcomes, fewer complications and reduced readmissions.

The American Medical Association has challenged a Georgia court’s blocking of a prompt payment law and in the process has raised questions about some of the pillars of federal preemption under the Employee Retirement Income Security Act (ERISA) as it relates to third-party administrators and self-funded insurance plans.

With a growing focus on continuity of care across settings, the Hospital Corporation of America North Texas Division (HCA) and First Choice Emergency Room, a freestanding emergency room system, have formed a partnership to increase access in Dallas-Ft. Worth region.

In January, the Affordable Care Act (ACA)’s individual mandate will enter the next phase of its roll out. Millions of uninsured Americans will face penalties if they do not enroll in a health plan. Uninsured problem solved, right?