Author: Super User

As patients take more control of their healthcare decisions — including where they receive care — hospitals and health systems are focusing on improving patient access.

The payment landscape is undergoing profound changes as a greater burden of healthcare costs move from insurers to patients.

A recent study found more than one-third of genetic tests ordered by a single medical center during a three-month period were misordered, resulting in $20,000 in unnecessary cost.

The steady rise in C-sections from 21 percent of births in 1996 to 32 percent today is a major quality and cost problem.

Ongoing developments in Washington have led many to question the future of healthcare reimbursement programs like Value Based Purchasing, Bundled Payments and other population health-driven initiatives.

Fast enrollment, fast reimbursement—that’s the name of the game for quickly earning revenue after joining a new health plan.

Of all the changes brought on by the Affordable Care Act (ACA), one of the most profound was its effect on the business operations of health payers. What was once primarily a business-to-business (B2B) transaction between payers and employers suddenly…

On April 1, 2016, the Centers for Medicare and Medicaid Services (CMS) launched the Comprehensive Care for Joint Replacement (CJR) Program.

Urgent care owners, operators, physicians and staff, take note: payers across the country are increasingly requiring certification or accreditation before contracting or as a requirement to remain in-network.

Health plans have long supplied their members with provider directories to assist in finding in-network physicians who are accepting new patients.