The Centers for Medicare and Medicaid Services on Monday proposed new rules to discharge planning requirements for long-term care hospitals, inpatient rehabilitation facilities, critical access hospitals and home health agencies. Under the proposed rule, hospitals and critical access hospitals…
With healthcare reimbursement quickly evolving to primarily a value-based model, many physicians fear the inevitable repercussions of not being prepared for contracting based upon patient outcomes. The unveiling of CMS’ Value-Based Modifier, the general market movement since the Affordable Care Act, the…
Since 1965, a lot has changed in the world of Healthcare policy. Medicare has opened doors to health care and increased economic security for hundreds of millions of older people, people with disabilities, and their families. Since 1986, the Center…
Since their inception, narrow networks have been expanding due to consumers being increasingly willing to have reduced provider choices in exchange for lower premiums. Insurance companies are able to keep the premium lower by taking out high-cost employers. In addition,…
Year Two of the ACA Coverage Expansions: On-the-Ground Experiences from Five States As of Spring 2015, states had completed the second open enrollment period for the new Health Insurance Marketplaces established by the Affordable Care Act (ACA) and most of…
Humana has posted a policy/coding update that will take effect on 9/14/2015: http://apps.humana.com/marketing/documents.asp?file=2642614 Unless otherwise noted below, these updates will be applicable across all of Humana’s product lines (commercial & Medicare): Humana addresses maximum dosages/acceptable diagnosis codes for several drugs…
Survey: Healthcare Finance, Reform Top Issues Confronting Hospitals in 2014 CHICAGO, January 12, 2015—Financial challenges again ranked No. 1 on the list of hospital CEOs’ top concerns in 2014, according to the American College of Healthcare Executives’ annual survey of…
The 340B drug discount program is currently under consideration for changes that will affect hospitals and physicians alike. Hospitals typically would like to keep the program how it is, while physicians are striving for reform. The drug discount program has been giving…
While change is sweeping across healthcare, there is a need of first-class physician leaders. In order to effectively support clinical integration, there needs to be mutual support and trust between physicians and hospitals. Another key issue for leaders to consider…
For the last several years now, anyone in the healthcare provider sector, has heard about or been highly anticipating the move to ICD-10. The upcoming change will obviously require investments to be made, but will be more costly to those…