The company, Executive Health Resources, is often at the center of battles between hospitals and Medicare over how the facilities bill, reports The New York Times. Meanwhile, more health providers are participating in Medicare's experiments with bundled payments.
The New York Times: UnitedHealth, An Insurer Switching Roles, Helps Hospitals On Medicare Billing
To hospitals, billions of dollars depend on how they define a patient’s stay. Even though a patient may be in the hospital for a simple surgery, Medicare might classify the procedure as outpatient care and pay a lower fee to the hospital. ... UnitedHealth also owns a little-known consultant that is flourishing by helping hospitals exploit what they describe as a gray area in Medicare payments for hospital stays, fighting to get what can amount to thousands of dollars more per patient. The consultant, Executive Health Resources, is often at the center of battles between hospitals and Medicare over how the facilities bill (Abelson, 6/30).
Modern Healthcare: CMS To Expand Bundle Payment Initiative
More hospitals, nursing homes and healthcare providers are poised to join Medicare's ambitious test of bundled payments, and the expansion underscores federal policymakers' eagerness to accelerate reforms in healthcare financing -- even ahead of evidence that new models will succeed (Evans, 6/30).