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The first piece of prescription-drug pricing legislation emerged from a unanimous vote on the House Ways & Means Committee in April. That means the Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act is well on its way to passage [...]
Why is credentialing important? Credentialing is the process of gaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a health care organization. Industry-recognized credentials help employers to validate the information and skills [...]
Accountable care organizations (ACOs) are part of the foundation of the healthcare industry’s transition to value-based care and purchasing. The federal government says ACOs could do more to reduce costs and improve care quality. And the organizations can achieve [...]
Diagnosis coding is becoming more and more important. The shift from volume to value requires HCC coding for patient acuity not just diagnosis coding for medical necessity. As the healthcare reimbursement process shifts towards a Value-Based model, Fee-for-Service will [...]
Low-value health payer plans and short-term health plans are just to attract consumers for profits with fewer services being provided shortly. Those individuals who were between jobs or in other situations in which they could not obtain their health [...]
