Payers

Final Rule concessions under MACRA may just delay implementation of new payment model, and together CMS and Vermont create single, state-wide ACO.

Negotiating the rate increase you want from a payer is a "war of attrition," says one expert. Here are 10 ways they'll try to trip your practice up.

The Triple Aim has created immense pressure to integrate the care we provide into the larger healthcare system, at great cost to our practice.

Blue Cross Blue Shield is jumping ship, here's what you need to know, and how it might affect your practice.

In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.

You've seen Trump vs Clinton. The Pearls podcast looks at another debate: Should the Affordable Care Act be repealed or not?

The Great American Physician Survey reveals that doctors find their profession more stressful and less lucrative than in the past.

As Anthem and Cigna aim to merge, reports say the two companies have been sniping at each other. Also, are fitness trackers effective in weight loss?

In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.

In an era of delivery and payment reform, with an imbalance of costs and savings in care, there are complex challenges behind team-based care.

Scheduling well-child exams in our practice has become a study in complexity, as we try to accommodate both payers and parents.

Rising patient deductibles and cost sharing not only hurts patients, but also can put pressures on medical practices to manage their revenue cycle.

With so many clinical restrictions in healthcare right now, physicians and their medical expertise might just become redundant unless something is done.

Medicare's new payment program under MACRA will place pressure on independent physician practices, as they compete for limited Medicare bonuses.

Learning to avoid common and costly mistakes when accepting and processing card payments can add up to big savings for your medical practice. [Sponsored]

Keeping up with the changes in the insurance industry right now is like herding cats. Here's what is on the horizon.

Their practice was founded on the principle of affordable care for patients, while providing a good living for its owners. Now that dream is fading.

New research from the MGMA indicates that physician-owned multispecialty practices are paying $32,500 per full-time physician for various IT expenses.

There are four payment technologies to put on your radar as you prioritize plans for upgrades or the installation of new technology. [Sponsored]

How do physicians view meaningful quality metrics, as defined by CMS? Not favorably, according to one survey.

Two lawyers share a way that healthcare providers can challenge insurer recoupments in the ongoing struggle with payers relating to provider reimbursement.

Despite resistance from providers, patients, and the DOJ, Anthem is not giving up on merging with Cigna. Plus, CMS hands out star ratings.

Stricter government standards for the FCA suggest that physicians who do not meet all measures of compliance could be required to refund claims payment.

Healthcare reform promises to improve care, reduce cost, and afford more people access to care. But at what cost will those goals come?

When using third-party vendors for certain practice functions, it's always wise to take a close look at their performance.

Could a delay to the start of MACRA be in the works? Also, what makes radiology a unique specialty when it comes to physician pay?

In this edition of the Physicians Practice Pearls Podcast, we speak with Anupam Jena, a researcher who studied the pay disparity between black and white physicians. Why do black physicians earn significantly less?

Successfully participating in MIPS or an APM will depend on meeting new measures and thresholds. Here are six key points to consider.

The 60-Day Rule, which forces physicians to return overpayments to CMS, was recently clarified. What should physicians know about it?