Category: Healthcare Finance News

Innovaccer research shows how AI could improve cost of care models

A new study from the company explores the ways its algorithms can be put to work improving risk scoring and stratification and enhance value-based care initiatives.

Change Healthcare rolls out new AI tech to help reduce denials

Change Healthcare HIMSS18 booth
The tool can help health systems optimize submissions and better predict potential issues with claims, the company says, giving recommendations to help mitigate denials before they’re submitted.

Proposed solutions to surprise medical bills a growing social risk for the healthcare industry, says Moody’s

The impact of legislation to curb surprise medical bills would be pronounced for those with lots of interaction with out-of-network patients.

EHRA to CMS on IPPS rules: focus ‘high-value’ measures, keep 90-day reporting

The HIMSS EHR Association tells the Centers for Medicare & Medicaid Services that the Promoting Interoperability Program needs consistency and specificity in its clinical requirements.

64% of senior finance executives are planning for risk in commercial contracts

New survey shows health executives are ready for increased risk assumption through commercial payers and Medicare.

Supreme Court will hear insurers’ argument for billions in risk corridors funds

At question is whether a temporary cap on funds makes retroactive payments moot, even as insurers upheld their part of the bargain under the Affordable Care Act.

Supreme Court will hear insurers’ argument for billions in risk corridors funds

At question is whether a temporary cap on funds makes retroactive payments moot, even as insurers upheld their part of the bargain under the Affordable Care Act.

Medical costs projected to increase 6 percent by 2020, says PwC

Utilization is still being dampened by high deductibles and other cost sharing, but at the expense of employee satisfaction.

President Trump signs executive order requiring hospitals and insurers to reveal their negotiated prices

American Hospital Association, America’s Health Insurance Plans, say order will raise prices.

UnitedHealth Group acquires PatientsLikeMe

Merger ideagram
The online patient community portal will now be incorporated into UnitedHealth Group’s research arm, which is focused on health innovation and improvement.