By John Schwartz – Our healthcare system has evolved based upon the need for a visit, planned or impromptu, to a medical provider. The inefficiencies, glut of utilization and exponentially rising costs that flow from it as funded by the long-standing “fee-for-service” payment methodology have been well chronicled to date.
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By Devin Partida – One of risk classifications common applications relates to the insurance industry. Insurers consider the overall risk associated with a physician or practice and then conclude whether to offer coverage. Here are some other helpful specifics about these groupings.
By Bernard J. Wolfson – A federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care.
By David Burda – One of our mantras at 4sight Health is that we won’t change the way we deliver care until we change the way we pay for care. Providers will do what you pay them to do, and if you want providers to do something else, pay them to do something else.
Latest news being reported on payers and the health insurance industry including news from athenahealth, CMS, Humana, UnitedHealthcare, Anthem, Blue Cross Blue Shield Association, UnitedHealth Group, CareSource, Cigna, Cotiviti, and more.
Eight hundred forty hospitals and inpatient organizations and fifteen hundred fifteen physician practices were represented in the sweeping Q1-Q2 2021 series of financial management IT user polls, as daunting challenges are forcing providers to advance their technologies to maintain solvency.
By Austin Dobson – The CMS Interoperability and Patient Access Final Rule requires patients to access their data which caught many U.S. payer organizations on their heels. It includes steep technical compliance climbs for teams that have never had to work with these standards or meet these requirements.
By Devin Partida – The COVID-19 pandemic caused drastic shifts throughout virtually all segments of society. Here are six ways the health crisis influenced trends in the insurance industry.
By Bernard J. Wolfson – In April, San Francisco-based primary care company One Medical revealed an eye-popping compensation package for its chief executive and chairman, Amir Dan Rubin. His $199 million payday, particularly noteworthy at a company that has yet to turn a profit, made Rubin the second-highest-paid CEO in the United States last year — but only on paper.