Posts Tagged ‘Medicare Claims Repricing System’

As the Medicare enrollee population is going to increase from 35% to between 45-55% by 2025, the relationship between payers and providers is often put to the test when addressing Medicare claims from different ends of the payment continuum. A more flexible approach than traditional fee-for-service is needed to meet the new healthcare market requirements,…

Cost-caps for health plans are gaining popularity. A relatively new solution to controlling health plan expenses, Medicare reference-based pricing (RBP), has been buzzing among employers and advisers alike. Referral-based pricing from Medicare lets employers save too, allowing them to control short- and long-term health care costs. In spite of all the buzz about reference-based pricing,…

The U.S. spends over $2.8 trillion on healthcare and an estimated 30% is waste! Along with the rapidly-rising healthcare expenses in the country comes a surprising level of inefficiency and waste. Total waste of healthcare expenses tends to cross over $840 billion each year.  Inefficient claims processes, administration plans, and non-compliance with the latest CMS…