Where healthcare challenges find solutions

Payment

Patients are increasingly reaching into their own pockets to cover the cost of healthcare. They want more information about costs and ways to conveniently pay their bills while providers want to maintain healthy margins. Read more about innovative payment tools.

Medicare officially kills 25% rule for long-term care hospitals

Medicare officially kills 25% rule for long-term care hospitals

The CMS' final inpatient pay rule ends a long proposed 25% rule affecting long-term care hospitals' Medicare reimbursements. The rule also finalized plans to overhaul the meaningful use program to offer incentives for interoperability. »

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Proposed site-neutral payment policy sets the stage for battle royale between CMS, hospitals

Proposed site-neutral payment policy sets the stage for battle royale between CMS, hospitals

As the CMS charts a path to level pay for outpatient services, it's also leading toward a head-to-head battle with powerful hospital lobbying groups as some providers win and lose with site-neutral payments.

Maryland's price transparency site adds new data, petition

Maryland's price transparency site adds new data, petition

Consumers can now sign a petition that lobbies Maryland providers and insurers to reveal their costs via the state's updated price transparency website.

Tennessee seeks to update strategy for hospital uncompensated care

Tennessee seeks to update strategy for hospital uncompensated care

Tennessee will ask for federal approval to update how it doles out uncompensated-care funds to hospitals. The move comes as facilities in the state face rising expenses and decreasing patient revenue.

Federal court receives AHA's ideas on fixing Medicare backlog

Federal court receives AHA's ideas on fixing Medicare backlog

A federal court has received the American Hospital Association's ideas on reducing the huge backlog of denied Medicare claims. A federal judge may mandate HHS to follow some or all of the ideas in order to curb the ever-growing number of appeals.

Late data for CMS bundled-pay program gives providers little decision time

Late data for CMS bundled-pay program gives providers little decision time

Provider groups have just two months to decide about participating in the CMS' Bundled Payment for Care Improvement Advanced program, but they still don't have the claims data they need to make that decision.

Doctors propose new Medicare direct-contracting model

Doctors propose new Medicare direct-contracting model

A group of doctor practices has united to develop a way the CMS can contract with practices to treat Medicare beneficiaries. Not everyone is on board, as some clinicians fear it could lead to rationing of care.

CMS considers paying all Medicare providers for cancer gene therapies

CMS considers paying all Medicare providers for cancer gene therapies

The CMS is considering reimbursing all Medicare providers for one-time cancer treatments that genetically alter patients' cells to fight the disease. The move could increase revenue by millions at each hospital offering the therapy.

New coalition urges greater support for independent docs in value-based payment models

New coalition urges greater support for independent docs in value-based payment models

The Medical Group Management Association and five other physician organizations formed a coalition to advocate for policies that support independent doctors transitioning to value-based payment.

New CMS nursing home model raises pay accuracy concerns

New CMS nursing home model raises pay accuracy concerns

Some nursing homes worry that CMS' proposed Patient-Driven Payment Model may pay them less for treating Medicare patients.

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