Hospitals & Providers

There are four key components at the root of the changing dynamic between payers and providers. Here’s what they are, and what to do about them.

The ER Savings Initiative is designed to deliver care in a hybrid model that collaborates with health systems to eliminate the unnecessary use and costs of their ERs.

In 2013, its first year taking part in CMS’ Shared Savings Accountable Care Organization (ACO) Program, Rio Grande Valley Health Providers saved nearly $12 million. Here, the CEO and CMO discusses the keys to success.

HHS has announced steps aimed at limiting short-term health plans and strengthening the marketplaces. Here's how you will be affected.

Precision medicine isn’t just about genomics anymore. With the field moving forward as the next step in population health management, environmental, social and lifestyle factors that live outside the medical system are increasingly important to target treatments and engage patients. That means health plans also need innovative technology solutions to capture, store and integrate this crucial information.

The goal of CMS’ proposal is to reduce costs while rewarding better outcomes for patients. Here are five things healthcare executives need to know.

The transition to value-based payment has accelerated rapidly over the past two years, and payers and providers predict even more dramatic changes.

Making these three changes to health insurance exchange plan offerings could attract more consumers and increase the likelihood of success.

Physicians need to be well-versed in the evolving government requirements for billing, reimbursement and overall healthcare delivery/patient experience. One expert outlines these important items for physicians to watch.

Humana's Bold Goal progress report aims to improve population health by addressing health barriers, increasing access to healthcare, encouraging healthy behaviors, and promoting the prevention and management of chronic conditions prevention and management.

Most patients hear the word “carcinoma” or “cancer” and believe they may die if they do not seek treatment. But ASCO researchers say that may be a problematic mentality.

Biosimilars will have a significant impact on cancer treatment, with the potential to drive cost savings, but will patients and providers be accepting?

Patient-reported outcomes are playing a growing role in cancer research and are poised to become an important part of regulatory review in drug development-and even routine clinical cancer care.

A look at how burnout affects providers, their patients, and the centers that employ them.

Determining what to measure, and how best to measure it, can be surprisingly complex-and appropriate metrics can vary between cancer types and patient populations.

The CDC says that one out of three older adults falls each year, making falls the leading cause of injuries for adults 65 and older. Here’s how some hospitals and programs are addressing the problem.

A discussion with Thomas H. Lee, MD, chief medical officer, Press Ganey

Industry experts are using their proprietary data/analysis to help structure contracts between pharmaceutical companies and plans.

Preventing drug shortages requires a “swat team” mentality by all, including FDA, manufacturers, group purchasing organizations (GPOs), and health systems. Here’s what healthcare providers should do about the issue.

Preventing hospital readmissions must be top of mind for payers and providers, says Jill Duncan, RN, executive director at the Institute for Healthcare Improvement, where she leads the Joint Replacement Learning Community.

Successful healthcare systems share their strategies for reducing hospital readmissions.

Studies have found that getting diabetes under control early on has immediate benefits. Here’s how providers and patients can more proactively address the disease.

Specific benefits patients with diabetes have experienced due to the ACA, and how those benefits are impacting diabetes costs.

A value-based cancer care model focuses on better aligning providers with health plans and employers through an IPA.

Probuphine implant could be a new option for addicts if obstacles, such as price, don’t get in the way.

CMS’ Comprehensive Care for Joint Replacement model will hold hospitals financially responsible for the quality and cost of hip and knee replacements.

Participants in a new CMS payment program will attempt to improve the effectiveness and efficiency of cancer care delivery. Here’s how.

Researchers from Leavitt Partners are using a combination of public and proprietary data to report on some early findings about ACOs.

The combination of unsustainable healthcare spending and the rapid growth of value-based reimbursement revenue models is driving the shift to patient-centered care across the continuum-or continuum-centered care.