The Healthcare Payments Industry Has a Perception Problem
Healthcare payments are no longer about transactions. It’s about controlling the revenue cycle. And increasingly, that control is not sitting with ISOs.
presented by
The 72-Hour Hurdle: Faster Prior Authorization is Exposing Healthcare’s Broken Billing Cycle
The healthcare ecosystem is fixing how quickly decisions get made, without fixing how quickly money actually moves. This isn’t a failure of reform. It’s evidence that reform is working — and revealing where modernization needs to continue.
presented by
TEAM is Here, and Hospitals Are Running Out of Time to Prepare
Organizations can take steps now, in the early months of the program, to position themselves for success by evaluating past performance, identifying opportunities for improvement, and implementing episode-driven clinical and operational workflows.
Mandatory by 2026: 5 Ways to Prepare for CMS’ TEAM Payment Model
For hospitals and health systems, the challenge is steep, but so is the opportunity. TEAM offers a framework to deliver more coordinated, cost-effective, and patient-focused care. Those who prepare now will be far better positioned to thrive in a value-based future.
Health Systems Are Still Missing Payments Because of the Change Healthcare Cyberattack
Six months after Change Healthcare suffered its cyberattack, some health systems are still missing payments for patient encounters from February, according to a new report. It showed that small hospitals are still missing about 3-5% of expected net revenue for patient encounters from February.
Hospitals Have Concerns About CMS’ Proposed $9B Lump Sum Payment for Illegal 340B Cuts
CMS recently proposed a $9 billion lump sum payment to remedy illegal payment cuts for 340B drugs from 2018 to 2022. In general, hospital groups have reacted positively to the fact that 340B providers will receive lump sum payments but have expressed concern about CMS’ methods for maintaining budget neutrality with this plan.
presented by
Top 7 Modern AI-Powered EAP Providers for Global Workforces in 2026
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
How Atrium Health Made Payment a Part of Its Digital Front Door
A health system's failure to offer patients with digital payment options could lead to slower collection times, create a disjointed patient financial experience, and result in decreased patient satisfaction and loyalty. At HIMSS23, Atrium Health's vice president of revenue cycle management shared how his system integrated payment into its digital front door and gave pointers to hospitals looking to do the same.
Specialty physicians in Connecticut gain path to value-based care, payment boost via private health plan
The State of Connecticut Health Plan is the first commercial plan in the country to have its episodes-of-care payment model designated as an Advanced APM by CMS. With limited Advanced APM options via CMS, this designation will provide specialty physicians in the state a path to value-based care payments through the private sector.
OIG: MA companies used chart reviews, health risk assessments to boost CMS payments
Overall, MA companies generated an estimated $9.2 billion in risk-adjusted payments for diagnoses listed only on chart reviews and health risk assessments, with the top 20 companies receiving more than half of the payments. OIG is urging CMS to provide more oversight.
CMS repeals MA rate disclosure requirement, boosts hospital payments by $2.3B
CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and increase payments to hospitals but will also require facilities to report Covid-19 vaccination uptake among its employees.
presented by
Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
Effort underway to help hospitals by suspending Medicare sequestration
Medicare sequestration is making headlines this week, as legislation to pause the 2% payment cuts moves through Congress. Here is a recap of what the sequester cuts are, why hospitals want it gone and how lawmakers are working to make that happen.
Simpler bills, more payment options can improve hospital billing experience
A new survey from healthcare revenue cycle firm Waystar shows that most patients find their medical bills confusing and delay payment because of financial constraints. But there are steps hospitals can take to improve the billing experience for patients.
CMS final rule requires state exchanges to bill separately for abortion coverage
The changes are expected to affect 1,467 health plans, increasing average annual costs by $1.07 million.
Report: UnitedHealth picks up healthcare payments company Equian in $3.2B deal
Indianapolis-based Equian processes more than $50o billion in healthcare claims annually and works with nine out of the top 10 healthcare payers.