Healthcare financial leaders often lack a true understanding of the cost of care across service lines or populations. Focusing too much on clinical data from the medical record can lead to overlooking critical claims and demographic data.
If millions of Americans drop their healthcare coverage, providers will be forced to bill patients directly and see fewer collections. They also will see more and sicker patients in emergency rooms, already a cost center for hospitals.
A recent survey shows that more than half of consumers determine the price before receiving healthcare. Physicians and health systems will need to respond to the movement toward price-based decisions in healthcare.
CMS may appear to be slowing the path to value-based care by ditching some bundled payment models, but a new program could revitalize the effort. The new initiative will draw in more physicians who were not attracted to the earlier versions.
Similar services for mental health are reimbursed differently according to the treatment setting, a report finds. Mental health services also involve more out-of-network coverage than other healthcare.