Healthcare News & Insights

Major payor stops coverage for non-emergency conditions treated in EDs

Non-emergency medical conditions treated in the emergency department (ED) will no longer be covered by Anthem in Georgia, Missouri and Kentucky – and this could be the sign of a growing trend among payors. 

5 essential skills your hospital’s nurses need

In an era of value-based care, your hospital’s clinical staff needs a unique skillset to meet the mark for various quality measures. This is especially true of your hospital’s nurses, who are on the front lines treating patients each day and are essential to your facility’s success. 

4 big changes for hospitals in proposed OPPS rule

The Centers for Medicare & Medicaid Services (CMS) recently released its proposed rule for the 2017 Hospital Outpatient Prospective Payment System (OPPS), and there are several changes coming that’ll affect how your facility bills for the services it provides. 

Concierge medicine could boost your bottom line

As a way to improve revenue while still providing high-quality care to patients, some hospitals have embraced a payment model more often seen in primary care practices: concierge medicine. 

How the 2016 Physician Fee Schedule will affect health IT

The Centers for Medicare & Medicaid Services (CMS) has some big plans for providers that would change how they use health IT and earn incentives for cost and quality measures. 

Feds announce value-based payment timeline

It’s not just a vague threat anymore: Value-based payments are coming – and soon.

Hospitals have mixed success with Medicare quality incentives

If your hospital is having trouble meeting Medicare’s new quality standards, you aren’t alone. Many of your peers are, too – and they’re facing some steep financial penalties from the feds.

3 chronic care hurdles hospitals should plan for

Providers can finally get paid for coordinating care for patients with chronic illnesses, but it won’t be all smooth sailing when it come to getting reimbursement for chronic care management (CCM).

Is now prime time to consider providing telehealth?

Telehealth is poised to be one of the industry’s fastest growing areas. And new regulations and federal legislation means it may be time for your facility to consider providing more telehealth services. 

Payments on the horizon for advance care planning?

A controversial topic — advance care planning — is being broached again despite opposition from certain groups.