By David R. Burda – The long-running debate over prior authorization typically is framed around patient care. PA delays or denials prevent patients from receiving medically necessary care when they need it. Within that frame is the administrative burden that PA puts on physicians.
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By David R. Burda – There’s an intriguing dance taking place right now among patients, physicians, telemedicine technology vendors, regulators and healthcare finance leaders. I’m not sure who will take the lead eventually, but it will be fascinating to watch.
By David R. Burda – A short research letter recently published in the Journal of the American Medical Association supports the idea that it’s providers and payers, not patients, that have created the revenue cycle mayhem.
By David R. Burda – The money flowing from Medicare into Medicare Advantage is like water gushing out of a frozen pipe. Here are the latest numbers from CMS, which released its annual national health expenditure figures on Dec. 13, 2023.
By David R. Burda – HCPLAN’s latest annual report is another reminder that the transition to APMs has stalled out. Many consider HCPLAN’s annual report as the gold standard for measuring the transition to APMs. It breaks down payment models into four categories.
By David R. Burda – Better check the byline on this blog post. It’s about patient safety improving at hospitals. Yes, I’m the author. I also try not to be a hypocrite. If I write about patient safety dropping hospitals, like I did in this monthly column, “Dead Patient Walking,” then I feel compelled to write about it when it gets better…
By David Burda – As you know, I’m more of a glass-half-empty, bad-news kind of guy, not a glass-half-full, good-news kind of guy. Especially when our health outcomes in the U.S. continue to fall below health outcomes in other high-income nations despite more providers having VBR contracts with commercial insurers. Big deal.
By David Burda – APMs are reimbursement models that put providers at financial risk for the care that they provide to their patients. APMs take many forms. The AMA report covers four basic forms: pay-for-performance, capitation, bundled payments and shared shavings.
By David Burda – Healthcare middlemen like group purchasing organizations, distributors and pharmacy benefit managers (PBMs) add costs to our already bloated healthcare system, not subtract costs through savings like they claim. If you don’t believe me, read this short but telling research letter in JAMA Health Forum.