Search results for Costs/Reimbursement

Reimbursement for one-stage exchange lags behind two-stage

NEW ORLEANS — Although one-stage exchange may effectively treat periprosthetic joint infection, results presented here showed reimbursement for one-stage exchange lags behind two-s...

An Unsustainable Reimbursement Model: A 12-Year Analysis of Compensation for Revision Total Hip Arthroplasty

Revision total hip arthroplasty (rTHA) is a complex and resource-intensive procedure. However, physician and hospital compensations have not evolved to reflect such complexity. The...

Women’s Health Surgeries Reimbursed at Lower Rates, Doctors Say

A decades-old system for calculating insurance reimbursements can undervalue gynecological operations, delaying patient care and increasing out-of-pocket costs. The post Women’s H...

Study examines how patient cost-sharing liability affects hospital finances

A Health Affairs report published April 6 examined how changes in patient cost-sharing liability can impact hospital finances. The study found that the combined i...

Cashless Claim vs Reimbursement: Which is better?

A couple of months ago, I went to the insurance department of an eye hospital to apply for a cashless claim for my mother’s cataract surgery. I usually chat with hospital staff, pa...

OIG Greenlights Cost-Sharing Subsidies for Medicare Enrollees in Medical Device Clinical Trial

On March 11, 2026, the Office of Inspector General (OIG) issued Advisory Opinion No. 26-05, concluding that it would not impose sanctions on a medical device company (Requestor) th...

Radiation Oncology Community Seeking Relief from an Emerging Crisis under 2026 Changes to Medicare Coding and Reimbursem...

Reimbursement Declines Emerge Under 2026 Medicare Changes Stakeholders from the radiation oncology community are reporting substantial declines in aggregate reimbursement during th...

<![CDATA[What Unexpected Costs do GLP-1 Patients Face?]]>

Payer contract renegotiation costs independent practices

A typical commercial payer contract for an independent practice gets signed once, usually under time pressure during credentialing, and then sits untouched for three to five years....

Healthcare Authority Newsletter - April 2026 #1

News Briefs - 2025 Hospital Expenses Rose by 7.5%, Workforce Expenses Up 5.6% - U.S. hospitals saw total expenses rise by 7.5 percent in 2025, according to the American Hospital As...

Comprehensive Cost Estimation of an Enhanced Recovery Pathway in Hip and Knee Arthroplasty Using an Expanded Time-Driven...

Total hip (THA) and total knee arthroplasty (TKA) are among the most frequently performed surgeries worldwide, creating a substantial financial burden. Enhanced Recovery After Surg...

<![CDATA[How Teams Should Quantify and Prepare for Potential Cost Ripple Effects]]>

FY 2027 IPPS Proposed Rule – Changes to Organ Acquisition and Reasonable Cost Payment Policies

On April 14, 2026, the Centers for Medicare & Medicaid Services (“CMS”) published the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule (the “Prop...

How Medicare changes affect medical billing contracts

Policy changes eventually become operating decisions Most coverage of Medicare payment changes stops at reimbursement. A practice reads that a rule changes payment for certain serv...

How Medicare changes affect medical billing contracts

Policy changes eventually become operating decisions Most coverage of Medicare payment changes stops at reimbursement. A practice reads that a rule changes payment for certain serv...

An Urgent Care Treated Her Allergic Reaction. An ER Monitored Her — For $6,700.

A bug bite and an allergic reaction ultimately sent a North Carolina woman to the emergency room, where she had a couple of brief chats with a doctor and a dose of medicine. Now sh...

Budget Reconciliation and Health Policy: Understanding the Legislative Process and Where Congress May Go Next

Key Takeaways The FY 2027 budget process is underway, with the president submitting his proposal April 3 and committees beginning hearings the week of April 13. Senate leadership...

Hospital Margins Squeeze as Costs Outpace Revenue Growth

Hospitals are still on quite fragile financial footing if you look beneath the surface, according to new Kaufman Hall data. Rising costs, uneven patient volumes, and ongoing reimbu...

The Influence of Regulatory Requirements and Evolving Reimbursement Models on Health IT Strategy for Payers and Provider...

As with all healthcare topics, the topic of payers and providers is very complex and multifaceted. So today, we are going to narrow our focus down to regulatory requirements and ev...

Why Does Health Care Cost So Much?

Readers, including health professionals, offer their analyses.

ACCESS Model: Technology as Key to Managing Chronic Conditions

Providers caring for patients with chronic conditions have for years faced a persistent mismatch between how care is delivered and how Medicare pays for it. Managing chronic illnes...

McDermott+ Check-Up: April 10, 2026

THIS WEEK’S DOSE Congress wraps up spring recess, turns toward reconciliation. Attention remains on the prospect of a reconciliation 2.0 bill to fund US Immigration and Customs E...

Costs of diabetic foot complications

The cost of diabetic foot conditions. Siriwardana HD, Weerasekera D. Ceylon Med J. 2007 Sep;52(3):89-91. OBJECTIVES: To estimate the cost of management of diabetic fo...

GLP‑1s, Direct‑to‑Consumer Pricing, and the HRA Opportunity Most Employers Are Missing

Why the Compliance Answer You’re Getting May Not Be the Answer You Need- If your company offers health benefits, someone has probably asked about GLP‑1 coverage in the last six mo...