By Dr. Jay Anders – In a Forbes Technology Council article earlier this year, my colleague Medicomp CEO Dave Lareau discussed how the industry was abuzz with talk about how providers and health plans can “optimize” risk-adjusted payments for Medicare Advantage, and the associated “upcoding” to qualify for higher risk scores.
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Latest news being reported on payers and the health insurance industry including news from Cohere Health, Humana, Cedar, CareSource, AHIP, UnitedHealthcare, Independence Blue Cross, CVS Health, Humana, Medica, Cigna, and more.
By Ram Krishnan – Today, behavioral health providers want to deliver effective treatment that brings hope and healing to patients. They also want to be reimbursed well and quickly so they can invest in the best resources and personnel. Value-based care can help providers achieve both.
By Tammy Hawes – Administrative waste, the excess overhead that occurs primarily due to the complexities between providers and payers including time devoted to billing and reporting, is the largest area of waste and accounts for $266 billion a year.
By Matt Fisher – Costs in healthcare are a frequent topic of discussion, with the focus of that discussion often going to the fact that costs keep rising. However, what is meant by healthcare costs? Once that is defined, how can healthcare costs be addressed in a way that is not currently being met?
By Tom Dorsett – The U.S. spent nearly $348 billion last year on prescription drugs, the highest in the world and an average of about $1,200 per person. To put this in perspective, Sweden spent about $350 per capita. High drug costs in the U.S. continues to be a threat to patient health and long-term outcomes.
Latest news being reported on payers and the health insurance industry including news from Cigna, UnitedHealth Group, Inovalon Inc., Independence Blue Cross, CVS Health, Humana, Aetna, AHIP, Gravie, Capital Blue Cross, Health Care Service Corporation, CareSource, and more.
More than 800 health care associations, ACOs, medical practices, and health systems urged leaders in Congress in a letter sent to extend incentive payments.
By David Burda – The debate over private-equity ownership in healthcare really centers around two questions: Will prices for medical care go up or down after a PE firm buys a provider organization? Will quality and service go up or down after a PE firm buys a provider organization?