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Reimbursement

June 5, 2020
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CMS issues more rule changes to cope with COVID-19 — are they enough?

CMS recently announced a second round of regulatory waivers and rule changes to expand care to the nation’s seniors and provide health care systems flexibility. Though physicians applauded the new measures, they also said that CMS could do more to help primary care physicians recover from the financial toll of COVID-19. Some of the latest actions include the following: Health care professionals can begin implementing these actions immediately, CMS stated.

March 27, 2020
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Care management and reduced LOS: How hospital leaders can connect the dots

A hallmark of hospital best practices in care management is the full engagement of physicians in the organization’s efforts to reduce patients’ length of stay (LOS).

When seeking to reduce costs, hospital and health system leaders have historically focused on streamlining or improving how they are deploying the organization’s resources, from labor to supplies to facilities.

March 27, 2020
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Pros and Cons of Urgent Care vs Primary Care Billing for Urgent Care Services

While it makes business sense for the minority of urgent care facilities that do contract with and bill insurance as a primary care practice, the majority contract and bill as urgent care, given higher reimbursement and the numerous other benefits this provides an urgent care operation.

 

Categories: Reimbursement
January 14, 2020
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18 things to know about Google in healthcare for 2020

Google has continued expanding its healthcare division, aiming to improve diagnostics and the clinician's ability to treat patients. But the move into healthcare had caused some controversy in how data is gathered and used. Here are 18 things to know about Google in healthcare. 

January 6, 2020
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Evolving toward engagement: The recent history of patient segmentation

Patient segmentation — classifying people according to their ability and propensity to pay their medical bills — has been around for a long time. In recent decades, technology that determines these classifications and updates the resulting profile has also improved the accuracy of these portraits of patients’ financial footing. Health system use of that information, however, hasn’t evolved at the same pace.

January 6, 2020
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'Medicare for All': What would it really mean for healthcare stakeholders?

In the spotlight as the 2020 presidential election cycle approaches, “Medicare for All” (M4A) is one of the most defining and contentious issues in politics. According to an August 2018 Reuters/Ipsos poll, 70% of people surveyed support M4A. Another survey indicates the underlying reason for Americans’ interest in healthcare reform: 77% are concerned that rising healthcare costs will cause significant and lasting damage to the U.S. economy, and 45% believe a major health event could leave them bankrupt, according to a 2019 Westhealth/Gallup survey. 

 

 

Categories: OP-ED Reimbursement
December 10, 2019
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How To Identify Patient Retention And Leakage ‘Forks In The Road’ And Choose The Right Path

Patient leakage from a health system network is an emerging critical issue facing healthcare leaders. As Medicare and Medicaid reimbursements continue to negatively affect operating margins for even high-performing health systems, competition for privately insured patients is increasing.

Categories: Reimbursement
October 29, 2019
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Utility of Point-of-Care Ultrasound Across Clinical Applications Spurs Continued Growth

With the miniaturization of technology, improved ease of use, lower system cost, increased portability, and greater access to training, the appeal of ultrasound continues to expand in point-of-care (POC) markets. Estimated growth in the POC ultrasound (POCUS) market is expected to exceed $3 billion globally by 2025,[1,2] up from $1.3 billion in 2018.

Categories: Reimbursement
October 29, 2019
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In the wake of recent news, providers should examine their patient collection practices to avoid pitfalls

Intermountain Healthcare Executive Vice President and CFO Bert Zimmerli recalls a conversation 15 years ago with a patient advocate about the challenges facing many patients with healthcare-related debt.

 “Most of them are overwhelmed,” the advocate told Zimmerli. “Some are clinically depressed. You would see a stack of bills on the table that they haven’t even opened because they know they can’t pay them."

Categories: Reimbursement
August 26, 2019
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Congress: Advance a Fair Out-of-Network Solution

ASPS Advocacy Summit attendees headed to the Hill in the midst of a heated congressional debate over how to address unanticipated medical expenses. Although all parties are committed to removing patients from billing disputes between providers and carriers, little consensus exists on how to execute that goal. Insurance companies, patient advocacy groups, the physician community, labor unions and others have all been lobbying for their own approaches.

Categories: Reimbursement

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