Latest news being reported on payers and the health insurance industry including news from Anthem Blue Cross and Blue Shield, IBX, CareSource, NAACOs, Blue Cross Blue Shield Association, CareSource, and more.
Read More
By Lynn Carroll – The dramatic loss of revenue by healthcare providers during the COVID-19 pandemic was a sobering reminder that healthcare organizations rely on the traditional FFS revenue model at their own peril. In response, more provider groups are implementing APMs built around financial incentives.
By Peyman Zand – A CereCore sponsored survey of executives and CHIME members, on their top concerns. Over 67% reported technical debt is a concern particularly around scope creep and costs, outdated IT infrastructure, problems maintaining systems or staying current with upgrades.
By Teri Gatchel-Schmidt – In the pursuit of delivering high-quality patient care, the complexities of healthcare management continually present challenges and regulation changes. Example, the Prior Authorization process, overloading medical staffs with administrative and resource demands.
By Ritesh Ramesh – Overcoding may net higher reimbursements for healthcare organizations, however the ramifications of getting caught far outweigh the revenue boost – and the likelihood of that happening are high as CMS continues its quest to ferret out fraud and abuse and recoup improper reimbursements.
Latest news being reported on payers and the health insurance industry including news from Independence Blue Cross, Aetna, CVS Health, Humana, CareSource, MultiPlan, ECHO Health, AHIP and more.
By Tom Dorsett – Drug costs are skyrocketing, but why? First we must understand the cause of high drug costs in order to properly address the problem. For more than twenty-five years, I’ve seen drug costs grow and dominate pharmacy budgets across the United States.
By Devin Partida – The healthcare industry experienced a steep increase in IT roles during the COVID-19 pandemic, but an economic downturn may force it to scale back. Cybersecurity is critical for compliance reasons, so hospitals must prepare their teams for the effects of a recession.
By Pamela J. Gallagher – The emergence of artificial intelligence is the topic on every healthcare leader’s mind. In many ways, though, AI is old news to those of us in healthcare finance. I can say from experience that once an AI technology comes onto the scene, there is no stopping it. AI is here to stay.