Protect Personalized, Independent Kidney Care
A pending CMS policy could cause havoc for independent kidney care facilities and patients who need life-sustaining treatments.
Biden Administration Extends ACA Coverage Eligibility to DACA Recipients
Under a new final rule, eligible DACA recipients will be able to enroll in a Qualified Health Plan through the ACA Marketplace or through a Basic Health Program.
Using Informed Awareness to Transform Care Coordination and Improve the Clinical and Patient Experience
This eBook, in collaboration with Care Logistics, details how hospitals and health systems can facilitate more effective decision-making by operationalizing elevated awareness.
Why Hospitals Are Condemning CMS’ Proposed Inpatient Payment Rule
CMS released a proposed rule this week that would boost hospitals’ inpatient payment rates by 2.6%. Hospitals groups have swiftly denounced this plan, arguing that this payment update is insufficient and will jeopardize hospitals’ financial stability.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
Insurer Advocacy Orgs Slam Final MA, Part D Rate Announcement
America’s Health Insurance Plans, the Better Medicare Alliance and the Association for Community Affiliated Plans all came out against CMS’ final 2025 Medicare Advantage and Part D rate announcement.
What to Expect from Your Language Services Provider during CMS Test Call Season
Performance on these test calls impacts the organization’s Star Rating, which is a marker of plan quality published on the Medicare Pathfinder. A lower rating can mean the loss of millions of dollars in reimbursements.
The Impact Brands: Empowering Wellness Through Natural and Holistic Solutions
In an era of escalating healthcare costs and a growing preference for natural, holistic approaches to health, The Impact Brands emerges as a collective of diverse brands dedicated to supporting overall wellness through natural means.
Despite Price Transparency Laws, Americans Are Nowhere Near Able to Shop for Care. How Can This Change?
Most hospitals and payers have publicly posted their pricing information, but experts think that data will remain mostly useless for consumers for at least another five years. Now that the data is available, healthcare software companies must step in and build tools that are personalized and easy to use. That way, consumers can eventually use price transparency data to shop for care.
Shifting Site of Service for Shoulder Replacements In Response to CMS Announcement
Based on the risk profiles of orthopaedic operations, a shoulder replacement is actually safer than that of a hip or knee and therefore an ideal candidate for the ambulatory surgical center environment.
Growing Awareness of Mental Health Importance Fuels New Initiatives, Research
Several recent developments signal increased support for psychological assessments and treatments.
CMS Finalizes Rule Streamlining Prior Authorization Process
CMS finalized a rule on Wednesday that included set deadlines for affected payers to complete prior authorization requests. Several organizations came out in support of the rule.
At ViVE 2024, Panelists Share Prior Authorization Progress and Frustration in Payer Insights Program
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Hospitals Finally Reached Widespread Price Transparency Compliance in 2023
Hospitals markedly improved their compliance with price transparency regulations in 2023, according to a new report. It found that more than 90% of hospitals have posted a machine-readable file containing gross charges, negotiated charges and cash prices for the services and items they provide.
HHS Launches New Medicaid Care Model To Improve Maternal Health Outcomes
HHS announced a new care model that aims to provide mothers with Medicaid coverage with more personalized maternal health care. This includes access to doulas and midwives and screening for health-related social needs.
The Transparency in Coverage Rule Doesn’t Go Far Enough: How to Make the Mandate Meaningful
The mandates set the framework and data requirements for transparency but consumers need more guidance for informed decision-making and comparisons. Health plans should be acting now to turn the conversation from compliance to true member engagement.
4 Senators Urge CMS To Collect, Publish More Data on MA Plans
In a letter to CMS, four senators asked for better data collection on the practices of Medicare Advantage plans, including when it comes to prior authorization.
CMS: 4.6M Choose ACA Marketplace Coverage
Of those who have chosen ACA Marketplace coverage so far in the 2024 Open Enrollment Period, 20% are new consumers and 80% are returning consumers, according to CMS.