Editor's Note Negotiating pay rates in the ambulatory surgery center (ASC) setting is a complex and evolving process that requires strategic planning, data-driven decision-making, and strong payer relationships, noted the speakers Amy Coletti, principal, ASC practice, and Matt Kilton, partner, at ECG Management Consultants at this year’s OR Business Management…

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Editor's Note Although the central tenets of value-based healthcare have not changed, in many cases implementation has been reduced to little more than reducing costs, to the detriment of clinicians and patients. In a session at the 2025 OR Business Management Conference in February, economist Susanna Gallani, PhD, examined this…

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Editor's Note Moody’s Ratings has shifted the health insurance industry’s credit outlook from stable to negative, according to a February 3 article in Fierce Healthcare. According to the article, the downgrade is due to escalating medical costs that outpace reimbursement rates. Analysts project an 8% rise in commercial market spending…

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Editor's Note As part of a larger initiative to ease access to care, insurance giant Cigna is tying compensation for senior leadership directly to customer satisfaction. Modern Healthcare reported the news February 3. The shift is part of a multi-pronged approach that also includes overhauling prior authorization requirements and limiting…

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Takeaways • Although the central tenets of value-based healthcare have not changed, in many cases implementation has been reduced to little more than reducing costs, to the detriment of clinicians and patients. • The right incentives, such as recognition and work support, can effectively inspire clinicians to deliver high value…

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Editor's Note Financial incentives can shape surgeons’ decision-making, but their effectiveness depends on the structure of the payment model. This is the central message of a January 26 article in Forbes reporting on two studies: one linking a sharp increase in hernia cases to a simple Medicare coding change, and…

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Editor's Note Health system leaders expect to face mounting physician challenges, shifting reimbursement models, and new growth opportunities throughout this year, according to VMG Health’s Health System Leader Expectations survey. Based on responses from 73 health system leaders, the report highlights the sector’s key trends and priorities for 2025. Key…

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Editor's Note Escalating administrative hurdles from insurers are heightening tensions between healthcare payers and providers who criticize the measures for threatening patient care, Modern Healthcare reported January 22. According to the article, policies attracting criticism include stringent prior authorization rules, claims denials, and new fees for appeals. For their part,…

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Editor's Note Healthcare data inaccuracies occur at rates as high as 26.9% in hospitals, with related inefficiencies costing providers up to $20 million annually, HealthLeaders reported January 8. According to the article, these inaccuracies stem from factors such as data entry mistakes, outdated information, inconsistent data standards, and system integration…

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“Surgeons are the only people trained to provide surgery—life-saving care," says Carrie Zlatos, chief of legislative and political affairs at the American College of Surgeons (ACS). "They are an essential element of a community-based healthcare system. Regardless of where you live, everyone should have access to full quality surgical care.”…

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