HFMA
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HFMA
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Contract Year 2027 Revisions to Medicare Advantage and Medicare Prescription Drug Benefit Programs Proposed Rule Summary
HFMA presents a detailed summary of a proposed rule that would revise the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and Medicare cost plan regulations for Contract Year 2027. Comments on the proposed rule are due by January 26, 2026.
Reimagining the patient financial experience
Patients judge their healthcare experience long before they see a clinician. In an era of consumer-driven healthcare, transparency, affordability and ease of use are now as critical as clinical outcomes. Yet, while the care experience has evolved, the financial journey still lags behind. Hospitals that elevate the patient financial experience — making it as seamless,…
CY 2026 OPPS/ASC Final Rule Summary
HFMA presents a detailed summary of the CY 2026 final rule for Medicare’s hospital outpatient prospective payment system and ambulatory surgical center payment system (CMS-1834-FC) published in the November 25, 2025,Federal Register. Policies in the final rule will generally go into effect on January 1, 2026, unless otherwise specified.
CY 2026 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates
HFMA presents part three of three detailed summaries of a final rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies. Policies in the final rule generally will take effect on January 1, 2026. Part III covers the updates to the Quality Payment Program, including the Traditional Merit-based Incentive Payment System (MIPS), MIPS Value Pathways, and the Alternative Payment Model Incentive.
CY 2026 Physician Fee Schedule Final Rule Summary Part II – MSSP Requirements
HFMA presents part two of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies. The policies in this final rule generally take effect on January 1, 2026. Part II covers the Medicare Shared Savings Program Requirements.
Survey of revenue cycle executives points to the need to move from reactive to proactive clinical documentation
Review this report to learn how to swap out the processes and technologies that don’t support an effective, sustainable approach to clinical documentation. Revenue cycle teams will get key takeaways to rethink documentation as a proactive strategy rather than a back-end fix.
Tailored solutions enhance healthcare operations and patient satisfaction
When leveraging advanced technologies, healthcare organizations can address their most pressing challenges, such as revenue cycle inefficiencies, workforce shortages and regulatory complexities. Read more about tailored solutions that handle the complexities of financial and operational processes.
Providers should evaluate vendors on alignment with mission and long-term goals
Review how one company's Complete Business Office (CBO) services optimize the revenue cycle from end–to-end to relieve health systems' pressure of fewer resources, staffing shortages, rising costs, payer complexity and regulatory demands.
CY 2026 Physician Fee Schedule Final Rule Summary – Part I
HFMA presents part one of three detailed summaries of a final rule relating to the Medicare physician fee schedule for CY 2026 and other revisions to Medicare Part B policies. Policies in the final rule generally would take effect on January 1, 2026. Part I covers sections I through III.G (except for Section III.F: Medicare Shared Savings Program Requirements) and the Regulatory Impact Analysis.
Redesigning denials management in the OBBBA era
Under OBBBA, executives face denials as a continuous operational and financial pressure. Traditional reactive approaches — reviewing and appealing after denials occur — are no longer sustainable. The organizations that succeed in this new era will use predictive analytics, automation and disciplined processes to prevent denials before they happen. The problem with the traditional model For decades,…