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ASC-payer negotiations: 1 CEO's advice for securing the right contracts
Negotiating contracts with commercial payers is one of the most challenging and fatiguing aspects of an ASC administrator's role. But there are core strategies administrators should consider when sitting at the table with insurers, including arming oneself with cost and outcomes data, understanding the market and fostering good relationships with negotiators. -
UnitedHealth vs. Anthem vs. Cigna in Q2
Payers UnitedHealth, Anthem and Cigna are some of the largest insurers by membership. -
Prior authorization in 2022: 13 updates
Healthcare providers have been pushing for prior authorization reform this year, and many states are passing legislation to remove prior authorization requirements. -
'Depersonalization' of medicine likely to continue amid CMS physician pay cuts, physician says
CMS' plan to cut physician pay by 4.42 percent in its Medicare physician fee schedule proposal is leaving many physicians worried about healthcare becoming more impersonal. -
Value-based care in 2022: 15 updates
ASCs are looking to value-based care as the industry pivots to support bundled payment models. -
UnitedHealth buys Kelsey-Seybold-affiliated insurer
UnitedHealth Group, the nation's largest operator of Medicare Advantage plans, acquired Texas Medicare insurer KS Plan Administrators, the Star Tribune reported Aug. 16. -
$38M healthcare fraud scheme lands Miami physician in prison
A Miami physician has been sentenced to federal prison for committing a $38 million healthcare fraud scheme, the Justice Department reported Aug. 3. -
4 states update their noncompete laws
Four states and Washington, D.C., have recently updated their governance of agreements that prohibit employees from competing with businesses directly for a specific duration of time after their employment has ended, according to a Aug. 2 report from the National Law Review. -
Tennessee independent physician group adopts value-based care model
The Jackson (Tenn.) Clinic, one of Tennessee's largest independent physician groups, has adopted a value-based care model, the group said Aug. 2. -
CMS ups inpatient rates 4.3% for 2023; what should ASCs expect?
CMS plans to boost acute care hospital pay 4.3 percent next year, as long as the hospitals comply with quality data reporting. -
UnitedHealth in the headlines: 14 updates in 60 days
UnitedHealth Group, parent company of Optum Health and ASC management company Surgical Care Affiliates, saw a busy June and July. Here are 14 UnitedHealth updates from the last 60 days: -
Centene in the headlines: 12 updates in 60 days
Centene is one of the nation's largest health insurers by membership. Here are 12 updates from the company in the last 60 days: -
Aetna in the headlines: 5 updates in 30 days
Aetna, a CVS Health company, insurers about 39 million people. Here are five updates from the company since July 5: -
4 biggest payer moves this month
Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive. At the same time, physicians are balking at some payer moves in the last 30 days. -
Payers are pushing physicians to ASCs
Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive, according to ASC leaders. -
Elevance in the headlines: 7 updates in 30 days
Elevance Health, the insurer formerly known as Anthem, is one of the biggest payers by members with 39.9 million members. -
How CMS' physician conversion factor changed over the last 10 years
Physicians face another year of fee cuts in 2023 as Medicare proposes to reduce the conversion factor by 4.42 percent to $33.08. -
10 procedures CMS proposes moving off the inpatient-only list in 2023
Medicare is recommending removing 10 procedures from the inpatient-only list in 2023, according to its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rule, released July 15. -
Payers updating policies for ASC procedures
Four payers have updated their policy for ASC procedures since May 24: -
Cigna reconsiders latest reimbursement policy
Health insurance company Cigna is delaying the implementation of its modifier 25 policy.
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