Payer Redirection of Outpatient Care: What You Need to Know

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Insurance payers have recently issued a number of policies aimed at redirecting patient care with the goal of steering patients to treatment outside of hospital settings. In their attempts to do so, payers are disregarding prexisting contracts with providers and complicating the patient experience and pre-authorization processes. These policies make it increasingly difficult for providers to deliver exceptional patient experiences without a negative impact on their bottom line.

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The Top 5 Payer Trends Impacting Reimbursement and Tips to Combat the Pressure

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Recent regulatory updates and payer policy changes could have a big impact on providers’ operations and bottom line. Ensemble’s experts break down the top five macro-trends you and your organization need to know about now to avoid underpayments, denials, and impacts on patient volume. Trend #1: Payers becoming providers The line between payer and provider

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