The Great Resignation forced employers to focus on how they can improve healthcare benefits to retain talent, but employers and employees have differing opinions on healthcare coverage. As the Great Resignation sweeps across the US, employers and their human resource teams are often misaligned with employees regarding health insurance coverage and the role healthcare benefits […]
During the Delta and Omicron surges, hospitals and health systems faced significant challenges, prompting AHA to ask Congress for additional COVID-19 financial support. The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on the Medicare sequester relief. […]
Medicare Advantage beneficiaries who received care under value-based payment models, including two-sided risk models, saw lower acute care use than beneficiaries under a fee-for-service model. Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in […]
The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
There are barriers to telehealth adoption that physicians must overcome to realize the technology’s promise. Telehealth clearly has crossed a threshold of acceptance and now is viewed by physicians, payers and patients as an essential part of healthcare. It’s no surprise Fortune Business Insights predicts the telehealth market will reach $636.4 billion by 2027. That’s […]
On Wednesday, February 23, 2022, a federal court in Texas struck down five controversial portions of the interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) that implement the independent dispute resolution (“IDR”) process of the No Surprises Act (“NSA”). The portions of the Rule at issue set forth certain parameters […]
Honing your approach when negotiating with insurers can lead to better reimbursement rates. Last I checked my plumber charges me more than some physicians make for some services. It’s not to say that plumbers don’t work hard, but they certainly didn’t have to invest an inordinate amount of time and money to get specialized degrees. […]
Low-performing hospitals to see a 1 percent cut in Medicare payments under HAC Reduction Program in 2022. The Centers for Medicare & Medicaid Services (CMS) announced last month that 764 hospitals will face Medicare payment cuts in fiscal year (FY) 2022 under the Hospital-Acquired Condition Reduction Program (HACRP). The value-based program may reduce Medicare payments […]
Mississippi’s Medicaid program ranks poorly for its access to and quality of care, but Medicaid expansion could increase healthcare coverage along with lowering state Medicaid spending. Mississippi could achieve lower state Medicaid spending over the course of five years by expanding its Medicaid program with the American Rescue Plan boost to federal matching, a Manatt […]