Administrative healthcare spending totaled $812 billion in 2017, representing over one-third (34.2 percent) of total expenditures for physician practices, hospitals, long-term care, and private payers,...
Rise in childbirth complications is increasing overall hospital costs. But US hospitals could save nearly 20 percent of these costs by addressing serious conditions linked to preventable harm and...
Beaumont Health and Summa Health signed a definitive hospital merger agreement to make Summa Health a subsidiary of Beaumont Health after the two organizations signed a letter of intent last...
The Trump administration announced on Monday that it has picked Brad Smith to serve as director of the CMS Innovation Center (CMMI), where he will oversee the development and testing of value-based...
The American Medical Association (AMA) recently issued a checklist for physician practices to use when adopting evaluation and management (E/M) coding and documentation changes slated to take effect...
Tying Anti-Kickback and Stark Law reform to the level of financial risk providers assume creates more complexity and burden and could impede the transition to value-based care for physicians, advocacy...
340B hospitals are getting reimbursed three times the amount they initially paid for brand medications under the drug pricing program, according to a new analysis conducted by Milliman and commissioned...
Hospital price transparency is coming to New York, according to an announcement from the state’s governor.
Governor Andrew M. Cuomo unveiled on Dec. 27 his plans to create a consumer-friendly...
HHS’ Office of Inspector General (OIG) is taking steps toward “much needed reform” of Medicare fraud laws, but more can be done to remove the value-based care barriers presented by...
Healthcare Price transparency tools can provide accurate real-time estimates of ambulatory procedures. And a new cost estimation tool showed an 83.9 percent accuracy rate among patients, according to a...
California Attorney General Xavier Bacerra recently announced a $575 million settlement with Sutter Health to resolve the health system’s alleged anti-trust behaviors, which a class action...
Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts...
Hospitals will still get paid the reduced rate for certain clinic visits in 2020 despite a federal judge striking down the site-neutral payment policy earlier in 2019.
In an opinion filed on Dec. 16...
CMS announced in a newsletter last week that the agency will automatically reprocess claims for hospital outpatient services performed in calendar year (CY) 2019 to abide by a federal judge’s...
The low-volume payment adjustment, new rural hospital designations, alternative payment model demonstrations, and other payment reforms are key to improving access to rural healthcare, the American...
Hospitals are fed up with CMS’ plan to survey 340B hospitals to obtain drug acquisition cost data for drugs covered under the program. In a letter to CMS, 340B Health recently asked CMS to...
Supplemental hospital payments from Medicare were overstated by $502 million for 60 hospitals because of limits on the reconciliation process for outlier payments that stops contracted reviewers from...
Specialists who can surprise bill – emergency medicine and ancillary physicians – had significantly higher provider charges compared to Medicare payment rates versus other specialists, a...
A committee that advises Congress on how to adjust Medicare reimbursement rates recently mulled over payment recommendations for 2020and beyond, including freezing ambulatory surgery center (ASC)...
Four leading healthcare associations and three hospitals filed a lawsuit today against HHS over the recently finalized hospital price transparency requirement that mandates the disclosure of...
