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Payment

As providers and the government try to lower healthcare costs, much of the action rests on lower reimbursement. Meanwhile, patients increasingly are reaching into their own pockets to cover their healthcare costs. They want price transparency and convenient ways to pay their bills, and providers want to maintain healthy margins. Read more about how payment innovations affect the industry.

Azar's reference drug pricing model makes inroads with GOP

Azar's reference drug pricing model makes inroads with GOP

The Trump administration's idea to tie Medicare drug spending to other countries' lower prices is popular with progressive Democrats, but can HHS Secretary Alex Azar bring Senate Republicans on board? »

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Medicaid block grant waiver reports revive hospitals' funding worries

Medicaid block grant waiver reports revive hospitals' funding worries

The Trump administration is quietly considering allowing states to apply to convert their Medicaid programs into block grants that cap federal spending, which some experts say would lead to lower Medicaid payments for safety-net hospitals.

Plans, providers split on easing Medicaid network adequacy standards

Plans, providers split on easing Medicaid network adequacy standards

Health plans clashed with providers and consumers in their reactions to the CMS' proposal to give states more flexibility in regulating the adequacy of provider networks in Medicaid managed-care plans.

Hospitals' solution to surprise out-of-network bills: Make physicians go in-network

Hospitals' solution to surprise out-of-network bills: Make physicians go in-network

Some hospitals have turned to a bold strategy to prevent patients from receiving surprise medical bills from out-of-network providers: requiring in-hospital physicians to contract with the same insurers as the hospital.

Verma: Chargemaster rule is 'first step' to price transparency

Verma: Chargemaster rule is 'first step' to price transparency

The CMS is working to improve a new rule requiring hospitals to post chargemaster prices on their websites after experts said the data wouldn't help consumers, Administrator Seema Verma said Thursday.

Congress revives flurry of drug pricing legislation

Congress revives flurry of drug pricing legislation

The House Oversight Committee set a hearing on high drug prices for the end of January, and lawmakers this week rushed into the drug pricing debate. But the jury's still out on how aggressive Congress will get.

Hospitals vary in publishing CMS chargemaster prices

Hospitals vary in publishing CMS chargemaster prices

Price transparency stumbled out of the gate last week as hospitals complied with a new CMS requirement to publish their retail charges online for individual services and diagnosis-related groups.

Funding cutoff looms for model mental health clinics

Funding cutoff looms for model mental health clinics

Mental health leaders in eight states are worried about losing federal funding for a Medicaid demonstration that enables them to offer a broad array of services for people with serious mental illness or substance use disorders.

Rubio launches DSH overhaul debate in Senate

Rubio launches DSH overhaul debate in Senate

With scheduled DSH payment cuts looming next year, Florida's GOP Sen. Marco Rubio has introduced legislation to overhaul the current formula, which is weighted against his state.

Phase in DSH hospital cuts, overhaul policy, Medicaid panel advises

Phase in DSH hospital cuts, overhaul policy, Medicaid panel advises

The advisory panel will recommend that Congress slowly phase in disproportionate-share hospital cuts, due to start in October, but will not suggest that lawmakers continue delaying them.

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