Claims Processing
Similar to the COVID-19 vaccine, Medicare will cover these infusions for the duration of the public health emergency.
Although RAND said price regulation is the most effective way to reduce spending, the researchers said this method has the most opposition.
Prior authorization continues to be the area with the lowest adoption rate, with only 21% of medical plans having fully electronic transactions.
Rule requiring payers to implement APIs for data sharing and to streamline prior authorization is “half-baked,” AHIP says.
The data will be used in a study to assess how physician practice mergers and hospital acquisitions of physician practices affect the marketplace.
Getting paid has become imperative during a time when both hospitals and patients may be cash-strapped.
Northwell reportedly sued thousands of patients last year for unpaid medical bills averaging $1,700.
The report found that 53% of hospitals in the bottom quartile of the area wage index for 2020 were in rural areas.
Consumer Reports hails passage as being good for providers who feel pressured into contract terms that benefit insurers.
Negotiations of drug prices are to be based on clinical outcomes; if the drug is not effective, the payer is not held accountable for the full price.