News
Approaching and dealing with commercial payers is "very much a game," but by understanding current trends in denials and learning the best practices for documenting and demonstrating medical necessity, managed care organizations can substantially reduce denials for inpatient care.
Integrity, compassion and perseverance are the key traits of an effective leader, Captain Chesley Sullenberger, who successfully landed a plane on the Hudson River in January 2009, told an audience of healthcare financial managers at HFMA's ANI conference in Las Vegas on Monday.
Kaiser Permanente and the Social Security Administration on Monday announced a pilot program to exchange electronic health record information using the Nationwide Health Information Network (NwHIN).
New compliance measures and shifts in information technology stalled payer performance improvement in 2011 according to the seventh annual PayerView rankings released today by health IT company athenahealth.
Payer performance improvement remained flat in 2011, according to the seventh annual PayerView rankings released today by health IT company athenahealth.
In central Pennsylvania, Capital BlueCross and PinnacleHealth recently announced an accountable care arrangement (ACA), that officials with both organizations say is similar in design to the Medicare-based accountable care organizations (ACOs) being promoted by the Centers for Medicare & Medicaid Services (CMS).
A new report from the Battelle/Biotechnology Industry Organization shows that U.S. jobs in the biosciences industry are booming.
In its June 2012 report to Congress, the Medicare Payment Advisory Commission (MedPAC) focused on three areas: Medicare benefit design, care coordination for fee-for-service (FFS) Medicare and care coordination for those dually-eligible for Medicare and Medicaid.
Do you know what you do best? Traditionally, that's a question many healthcare providers may not ever have bothered to ask themselves. That's because under the fee-for-service model which has shaped healthcare in this country for years, providers really haven't needed to know which parts of their practices were the most efficient or resulted in the highest health outcomes. Just so long as they were compensated for the services they provided.
Healthcare providers are being told they need to change the way they deliver their services, and payers are being told they need to change the way they reimburse providers. One way to help bridge the divide is for payers to develop effective strategies and programs to deliver value-based reimbursement programs.