Payment Reimbursement and Managed Care

Medicare Advantage concepts come to Medicare fee-for-service with Geographic Direct Contracting Model

While the MA Stars Rating program is a bonus program where plans can earn additional revenue for achieving high scores, quality in the Geographic Direct Contracting program is treated more like a penalty, says HFMA's Chad Mulvany.

Chad Mulvany, FHFMA December 17, 2020

Connecticut’s launch of a bundled payment program for its employee health plan is part of an effort to save the state $185 million | HFMA

HFMA’s Chad Mulvany says some state governments, like Connecticut, have high enough volumes that COVID-19 may accelerate their adoption of value-based payment models.

Chad Mulvany, FHFMA December 10, 2020

5 tips to safeguard 20% payment increase for treating patients with COVID-19

Healthcare organizations should be careful to ensure their practices don't put their COVID-19 payments at risk.

Lisa A. Eramo, MA December 2, 2020

CMMI releases interim final rule detailing the payment model for separately payable Part B drugs

HFMA's Chad Mulvany says it is likely drug manufacturers will sue to stop the rule, and they may have several strong legal arguments that would at least delay, if not overturn the rule.

Chad Mulvany, FHFMA November 24, 2020

California v. Texas: What’s next?

HFMA's Chad Mulvany says we won’t know the outcome of the case until sometime in the first half of next year.

Chad Mulvany, FHFMA November 10, 2020

Physicians score well in Quality Payment Program but receive little for it

HFMA's Chad Mulvany says the Merit-based Incentive Payment System (MIPS) program needs to be simplified to allow all providers to participate without it being overly burdensome.

Chad Mulvany, FHFMA November 5, 2020

Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions

HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.

Chad Mulvany, FHFMA October 22, 2020

Congress alters the terms for Medicare loans

Recently passed legislation relaxes terms of the Medicare Advanced and Accelerated Payment Program loans for hospitals and and other providers.

Chad Mulvany, FHFMA October 1, 2020

Rand releases updated study of hospital payment variation in commercial market

HFMA's Chad Mulvany says it’s imperative that everyone in the U.S. supports safety-net hospitals, or there will be an increase in the disparities in access to basic healthcare services between the haves and have-nots.

Chad Mulvany, FHFMA September 25, 2020

Increased ACA uncertainty at the U.S. Supreme Court upon death of RBG

HFMA's Chad Mulvany says given the Supreme Court’s historically narrow view on severability, many legal experts doubt the court, even with its new makeup, will overturn the entirety of the ACA.

Chad Mulvany, FHFMA September 24, 2020
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