Reimbursement

The Centers for Medicare and Medicaid Services has temporarily suspended its review of short stay patient claims to give reviewers time to improve the standardization around the two midnight rule, CMS said in a June 6 update.

In a new rule issued Wednesday, CMS is shutting down loopholes that allow short-term plans to operate outside the policies governing the ACA's single risk pool.

Clinical event notifications promote well coordinated, patient-centric care for New York Health Plan members.

Medicare is ambulatory care's favorite insurer when it comes to getting paid faster, according to a new peer60 survey of close to 800 ambulatory care providers.

The portion of released prisoners with addiction problems who lacked medical insurance fell sharply after the health law's Medicaid expansion took effect, but drug-treatment rates for ex-offenders barely budged, a new study shows.

If you're one of the nearly 44 million Americans estimated to have a mental health condition, the 2010 health law is supposed to help you get treatment. Yet actually getting that help depends, new research suggests, on who you are and, to an extent, on your racial background. While more people overall are getting mental health care, it's still harder to do if you are not white.

Tapping into a Health Information Exchange to Manage the Healthcare Needs of a Complex Population

John Clark, population health program manager at UNC Health Care, said direct employer contracts that eliminate intermediaries and can really help a health system contain costs. But the approach comes with some risks.

Blue Cross Blue Shield of North Carolina is seeking $130 million from the government for payments owed for 2014, the insurer said.

As value-based reimbursement leads healthcare providers to dig deep for new technologies and create team structures to handle the switch, smaller providers are struggling to cover the costs.