Operations & Business Management

Latest Headlines

Latest Headlines

Small wellness initiatives, big savings for North Carolina State Health Plan

Even the simplest of wellness initiatives can reap big savings for payers, the  North Carolina State Health Plan said at the Health Information and Management System Society's annual conference in Chicago.

Ninth Circuit St. Luke's decision ignores the American healthcare transformation

Guest post by David Balto, an antitrust attorney who previously served as the policy director for the Federal Trade Commission, and James Kovacs, associate attorney at the Law Offices of David Balto...

CMS unveils new rating system for hospitals

There are five-star hotels and restaurants, and soon there may be five-star hospitals. The Centers for Medicare & Medicaid Services has introduced a new hospital rating system for patient experience that will be based on a five-star scale.

Medicare overpaid hospitals at least $2.6 billion

The Medicare program overpaid hospitals $2.6 billion for the treatment of critically ill patients between 2010 and 2013, the  Wall Street Journal  reported.

Mayo Clinic teams up with UnitedHealth to improve patients' 'financial experience'

UnitedHealth's Optum360 unit and the Mayo Clinic have started a provider-payer partnership to lower costs and improve the patient experience by streamlining their revenue management, according to the  Minneapolis Star Tribune.

Insurers want better FDA rules on medical devices

America's Health Insurance Plans sent a letter to Sen. Bob Casey (D-Pa.) this week warning about the danger of premature FDA approval for devices and lax oversight after they hit the market.

Pioneer ACOs cut spending, but model may discourage savings

In their first year, Medicare's Pioneer Accountable Care Organizations generated moderate spending reductions, with greater savings for ACOs that started out spending more, but the current model is not conducive to future savings, according to a study published in the New England Journal of Medicine.

SGR repeal won't save all docs from Medicare payment cuts

While providers and industry groups hailed Tuesday's long-awaited repeal of the controversial Sustainable Growth Rate formula, some doctors who treat Medicare patients will still see the 21 percent reimbursement cuts that the Senate's last-minute vote was intended to avoid,  The Hill  reports.

UnitedHealth partners with Mayo Clinic on revenue management, patient experience

Two heavy hitters in the healthcare industry--UnitedHealth and Mayo Clinic--are partnering to use revenue management to boost patient experiences and lower costs.

Population health relies on provider collaboration, nurse coordinators, data sharing

Population health management is a vital part of an insurer's overarching goal to lower costs and improve quality care. At Horizon Blue Cross Blue Shield of New Jersey, population health means partnering with providers to offer valuable claims information to help them better manage patients with expensive chronic conditions. To learn more about how Horizon has successfully managed its population's health,  FierceHealthPayer  spoke with Steven Peskin, Horizon's senior medical director for clinical innovations.