By Patty Hayward – The healthcare payer space has shifted radically in recent years, with evolving reimbursement models, the rise of healthcare consumerism, advances in technology, and a global pandemic that upended businesses.
Read More
By Matthew Albright – The issue of surprise billing has long plagued the U.S. healthcare system. The need for legislation to protect individuals from surprise billing is strikingly clear, as studies reveal that one in five emergency room visits result in an unexpected bill for patients.
By Susan Bellile – As we kick off 2022, one of the big questions surrounding interoperability is the status of the payer-to-payer data exchange rule. The requirement was part of the May 2020 Final Rule supporting the 21st Century Cures Act, and its enforcement was scheduled to start on January 1. However, in September CMS delayed enforcement pending future rulemaking.
By Teresa Younkin – As we start rolling up our sleeves to get to work in 2022, we already are seeing several trends that will continue to transform healthcare in the year ahead. Payers will have their work cut out for them and will be forced to adapt, with many modifications coming sooner than later.
By Mark Menton – The sometimes adversarial relationship between providers and health plans is well documented – and its patients who end up in the crosshairs of the fragmented healthcare system. Amid government mandates, evolving customer demands, and rapid-fire innovation, many providers and plans realize they can’t go it alone anymore.
By John D’Amore – On March 9, 2020, HHS announced two long-anticipated rules from the ONC and CMS designed to “finally deliver on giving patients true access to their healthcare data.” Some expected these deadlines to be a few years out, but HHS had other plans in mind:
By Suzanne Cogan – The relationship between payers and providers has come a long way over the last decade, as the push toward value-based care has shifted the dynamic between the two healthcare stakeholders.