Why Hospitals Are Losing the Financial Tug-of-War With Payers

Hospitals’ flat revenues are clashing with rising costs and excessive reimbursement denials from payers, said Rod Hanners, CEO of Keck Medicine of USC. He warned that policy efforts focused solely on limiting provider payments ignore the larger issue of unchecked profits among payers, drugmakers and other healthcare industry players. The post Why Hospitals Are Losing…

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Sarepta CEO: ‘We Have, I Believe, a Very Laudable History of Being Extraordinarily Transparent’

Sarepta Therapeutics knew about the death of a patient treated with its experimental gene therapy for a type of limb-girdle muscular dystrophy, but said nothing public for a month. Financial analysts lambasted Sarepta executives for failing to disclose the fatality when the company announced a restructuring that includes stopping work on this limb-girdle program. The…

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What the Outcome of the Election Could Mean for Medicaid

This brief examines the two presidential candidates’ records and other recent policy proposals that could inform starkly different directions for the program across key areas, including Affordable Care Act (ACA) Medicaid expansion, financing, eligibility, benefits, and cost-sharing, prescription drugs, long-term services and supports, and managed care.

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Healthcare revenue cycle challenges and how to overcome them

Revenue cycle management (RCM) challenges exist at every stage of the patient journey – from patient intake and registration to insurance eligibility, claims processing and collections. Creating administrative efficiencies, reducing claims denials, improving the patient experience and remaining compliant with payer requirements and industry regulations all play a role in successfully managing revenue cycles and…

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