Policy and Legislation
Nearly every healthcare organization and affiliated clinician group faces challenges when working to meet new models of care and payment delivery. One industry expert offers six pieces of advice to lower costs, improve care and maximize revenue in the ED.
Even as many states gear up for tougher insurance regulations under the federal health law, Maine lawmakers last year bucked the trend, loosening rules they blamed for some of the highest premiums in the nation.
According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.
As states across the country work to expand Medicaid and build health insurance exchanges, one challenge they will surely face is fraud.
It may come as a surprise that President Barack Obama and GOP vice presidential nominee Paul Ryan are pushing the same target rate for controlling federal spending on Medicare. Their approaches to curbing costs, however, are very different.
Congress must repeal the sustainable growth rate formula to stabilize Medicare physician payments, and CMS needs to adopt a series of strategies that would strengthen the Medicare program by enhancing the role of primary care physicians, said the American Academy of Family Physicians in a recent letter to CMS.
Hays Green, healthcare policy practice lead at WPC, a Nashville-based company that provides consulting solutions, has outlined five preparatory actions that providers can kickstart today to create a solid infrastructure to achieve long-term ACO goals. "These steps can help organizations enter the commercial realm of accountable care models on level footing," Green said.
Long-term care pharmacy provider, Omnicare, may have reached a settlement in a whistle-blower lawsuit brought against the company five years ago.
A corner of the healthcare industry publicly asked the Department of Health and Human Services (HHS) to consider jumping directly to ICD-11. Here's a look at the reasons why this option was not selected by HHS.
While health reform has been in motion for more than two years, the Supreme Court’s recent go-ahead on the Affordable Care Act solidified that change is on the way – change that will impact stakeholders across the entire healthcare ecosystem.