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Provider networks

Four reasons payers need to embrace the digital economyConsumer and provider expectations have changed as a result of the digital economy. Here are four reasons why payers need to start migrating their businesses in that direction.
Opinion: Who's to blame for surprise out-of-network bills?Across the country more states are taking steps to limit patients’ exposure to surprise out-of-network bills.
How to boost your Star ratingsThe Stars ratings are meant to ensure that every health plan is providing adequate services for members. For payers, meeting these ever-changing measures can be a challenge.
Low CAHPS scores? Try thisLow CAHPS scores are a problem for health plans, but they don’t give much information in terms of how plans can improve. Drill down surveys might be the answer.
Non-physician providers play critical role in optimizing carePwC report finds most primary care teams not designed to optimize care. Here’s how to mobilize non-physicians to create a care dream team.
CMS proposal to address antibiotic resistance: Key takeawaysTo participate in Medicare and Medicaid, hospital and critical access hospitals (CAHs) would need to meet new criteria.
Payer merger impact on provider reimbursementKaveh Safavi, senior managing director for consulting firm Accenture’s global healthcare business, shares how payer mergers will affect provider payments.
High-cost patient populations: 3 areas to addressThe solution to succeeding in value-based reimbursement models is to start inside the hospital with high acuity patients and build the systems that support them.
Hitting the ACO target
Hitting the ACO targetMore than 750 government and private ACOs are now in place, helping healthcare transition away from fee-for-service. Find out what's working and what's planned for the future.
Majority of Americans support ACA subsidiesTwo new polls show majority support for the Affordable Care Act (ACA) including the health insurance tax subsidies now under review by the Supreme Court.