Category: Hospital

Medicare Advantage contract

Avoiding Medicare Advantage Contract Pitfalls: A Guide for Physician Practices

It’s a story many physician practice owners know all too well. A hardworking doctor secures a promising Medicare Advantage contracts with a major payer, expecting substantial revenue—100% of Medicare fee-for-service rates. The new contract seems like a win: more resources for staff, improved facilities, and better patient care. Table of Contents Common Contractual Pitfalls Best […]
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Medicare Physician Pay Cuts

CMS Finalizes MPFS with 2.9% Medicare Physician Pay Cuts

The Centers for Medicare & Medicaid Services (CMS) has finalized its 2025 Medicare Physician Fee Schedule, which includes a 2.9% Medicare Physician Pay Cuts to physician payments. This decision, despite opposition from major industry groups, will impact healthcare providers and potentially patient access to care. The rule also includes several positive provisions, such as expanded […]
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TEAM: CMS’s New Value-Based Payment for Surgeries

The Centers for Medicare & Medicaid Services (CMS) is introducing a new way to pay for specific surgical procedures: Transforming Episode Accountability Model (TEAM). This mandatory model, starting January 1, 2026, will hold hospitals accountable for the cost and quality of care for 30 days after five types of surgeries: Lower extremity joint replacement Surgical […]
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Healthcare-Price-Transparency

60% of Consumers seek Healthcare Price Transparency

A survey shows that 60% of consumers who look for pricing information seek answers from their insurance companies, but healthcare price transparency should still be a priority for providers. Not many consumers are asking how much healthcare services cost but among those who do, they are seeking answers primarily from their insurance companies, according to […]
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in-network-complex-covid-19-hospitalizations-cost-more-than-128k

In-Network, Complex COVID-19 Hospitalizations Cost More Than $128K

COVID-19 hospitalization costs varied by state, with the highest in-network cost averaging $128,650. According to a new FAIR Health study, COVID-19 hospitalization cost varies by state, with complex hospitalizations for COVID-19 in-network average cost maxing out at $128,650. “Behind the numbers of our COVID-19 Cost Tracker are the individuals who have contracted COVID-19. As a […]
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Hospital Price Transparency Rule

Preparing for Hospital Price Transparency Rule Compliance

  In the latest Healthcare Strategies podcast, a healthcare lawyer explores hospital price transparency rule compliance and different strategies for solving the healthcare cost problem for patients. A global pandemic may not be enough to stop one of CMS’ more controversial rules from taking effect in just a couple of months. On January 1, 2021, […]
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Coronovirus Outbreak

Coronavirus: How Can Hospitals Prepare?

Last week, the coronavirus that originated in the Chinese city Wuhan continued to spread. The World Health Organization declared a global emergency, and the first case of person-to-person virus transmission was recorded in the United States. The coronavirus outbreak is reminiscent of other viral outbreaks in recent memory, including Ebola in 2014, and SARS in 2003. When viral […]
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