Description: Review of reimbursement methodologies APGs, APCs, Medicare ASC, discount on charges, commercial hybrid, methods and trends in contracting, impact on trent, benchmarking. Issue No. 44.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.

Description: Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements

Description: This short article presents the latest SOA health research report on alternative payment models for high-cost curative therapies.

Description: Article explores why many integrated delivery systems are struggling and what actions they need to take to succeed.