Top 10 Hidden Facts About Hospital Prices
Here are the top 10 hidden facts about hospital prices that answer questions about why it is so expensive and why the bills are so complicated.
Overhauling prior authorization: How to achieve better outcomes at a lower cost
An intelligent authorization platform relies on AI and machine learning to extract patient-specific data from a number of sources including the EHR. This helps health plans better anticipate, manage and optimize member outcomes.
Avoid surprises by preparing to implement the No Surprises Act
The clock is ticking down for payers and providers to comply with the No Surprises Act, which protects patients from balance billing for the most common ancillary medical services. Here's how to get your ducks in a row.
The modern-day twisted ethics of physician referrals
Patients would not prefer a referral based on her physician's employment arrangement rather than quality ratings but that is how our system is designed.
Consumers and physicians see eye to eye on why healthcare costs are increasing and how to solve the problem
Houston-based Texas Medical Center Health Policy Institute conducted a survey of more than 9,000 consumers and 450 doctors to unveil their perceptions of health insurance, healthcare costs and more.
Time for a staycation? Some American medical tourists may need only to hop county or state lines
The NYTimes points toward areas of the United States where surgeries may be much cheaper for some patients, in part due to programs trying to drive down costs, in a comment-driven follow-up to the newspaper’s article on medical tourism and the medical device industry. The California Public Employees’ Retirement System (CalPERS) program is the exemplar […]
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
In most states, consumers likely won’t see same premium reductions as in New York
New York’s announcement this week that insurance premiums would drop 50 percent next year for individuals buying their own coverage in new online marketplaces made good talking points for proponents of the health law, but consumers in most states...
Out of the ER and under regular care: Oregon CCOs help Medicaid beneficiaries
Forty-year-old Jeremie Seals has had a tough life. He left home at 14, and he says, his health isn't good. He had a heart attack when he was 35, he has congestive heart failure and nerve pain in his legs “real bad.” Jeremie Seals with...
The Medicare bundlers — or is it bunglers? — are coming!
My long-time self-paying patient opined that the end of fee-for-service payments (payment for what you get) was imminent. I lightheartedly asked her how physicians would be paid. Would they be housed in military barracks and given vouchers for necessaries? Perhaps she read section 3023 of the “Patient Protection and Affordable Care Act” (PPACA or “ObamaCare”), […]