This week’s healthcare news takes a look at new health plan ratings released by the National Committee for Quality Assurance (NCQA), a comparison of premiums between Affordable Care Act (ACA) plans and employer-sponsored plans, what virtual reality technology is doing for healthcare providers and patients, and an evaluation of the Centers for Medicare & Medicaid Services’ (CMS) bundled payment initiative.... Read More
The cost of healthcare continues to dominate headlines as the Affordable Care Act (ACA) expands managed care, and thus provides fraudsters with new opportunities to take advantage of the system. This new and complex healthcare landscape—along with its varied payment methodologies—has forced insurers to work more aggressively to contain their costs. One of the ways in which insurers can respond to this changing healthcare environment and address fraud, waste, and abuse (FWA) is by reducing billing errors.
This week’s healthcare news highlights the latest data from the U.S. Census Bureau that shows insurers have spent more on healthcare this year compared to last year, news from the Centers for Medicare & Medicaid Services (CMS) that avoidable hospital readmission rates have fallen by 8 percent since 2010, and an update on CMS’ newly proposed options for the Medicare Access and CHIP Reauthorization Act (MACRA).... Read More
For eight years, we’ve assembled some of the industry’s top minds to explore and discuss healthcare’s most pressing and key issues. Attendees from past sessions often remark that the learnings offered at this annual event are unmatched—VHC has become the event to grow, learn, and share the latest healthcare industry insights. Set against a backdrop of a brand new venue, JW Marriott Desert Springs Resort and Spa in Palm Desert, California, VHC16 has been teed up to offer many learning and networking opportunities—along with a few surprises.... Read More
This week’s healthcare news takes a look at why healthcare costs seem to be skyrocketing, the latest announcement from the Centers for Medicare & Medicaid Services (CMS) on electronic health record (EHR) eligible hospital payment adjustments, and why CMS should risk adjust for patients in joint-replacement programs.
This week’s healthcare news highlights efforts by the Centers for Medicare & Medicaid Services (CMS) to balance the field among Affordable Care Act (ACA) exchange markets, updates on ICD-10 requirement flexibility, and the latest pushback from providers on the Medicare Access and CHIP Reauthorization Act (MACRA).
Quality reporting continues to be closely aligned with financial success for health plans across the country, amplifying the importance of a year-round HEDIS® process rooted in best practices. While HEDIS measurement and reporting requirements and timelines are always subject to annual changes from NCQA, effective pre-submission planning streamlines the process and helps health plans achieve successful outcomes. Here, we provide important tactics to help you fine-tune your process and stay on track for HEDIS reporting in 2017. This includes recommended milestones for critical reporting steps as well as tips that can optimize your process for next year.... Read More
This week’s healthcare news takes a closer look at plan options for HealthCare.gov consumers in 2017, the correlation between Medicaid expansion and improved health outcomes, efforts by the Centers for Medicare & Medicaid Services (CMS) to crack down on patient steering, and the release of CMS’ second annual prescription drug data analysis.
This week’s healthcare news highlights details of the Centers for Medicare & Medicaid Services (CMS) new cardiac bundled payment program, how strong compliance programs may help deter healthcare fraud, Verscend’s appointment of Dr. Emad Rizk as chief executive officer and board director, and details of CMS’ final rule on a controversial 1.5 percent cut to hospital reimbursements.... Read More
The Centers for Medicare & Medicaid Services (CMS) released its 2015 Payment Transfer Report on June 30, 2016. Now that plans have had a chance to digest their results, we asked our in-house experts for insight on what plans should be considering as they prepare to begin submissions for benefit year 2016.