Payment Reimbursement and Managed Care

More policymaking likely as the 2020 presidential election approaches

HFMA's Chad Mulvany says given the Trump administration’s focus on transparency, it’s possible the Transparency in Coverage final rule could be released prior to the election.

Chad Mulvany, FHFMA September 22, 2020

CMMI announcement foreshadows more mandatory bundled payment models

HFMA's Chad Mulvany says based on recently announced changes to BPCI-A episodes, a mandatory model may be defined much broader than currently.

Chad Mulvany, FHFMA September 17, 2020

Business Group on Health’s Annual Survey: Large employers ready to take the reins on healthcare cost

Responses to the Business Group on Health's annual survey of its large employer members suggest employers are tired of waiting for providers and plans to figure out how to reduce healthcare cost.

Chad Mulvany, FHFMA September 11, 2020

HFMA provides insight into 3 key areas of CMS’s 2021 IPPS final rule

HFMA's Chad Mulvany offers insight on key areas of the Inpatient Prospective Payment Service final rule, including market-based MS-DRG weights, Uncompensated Care DSH and Medicare bad debt requirements.

Chad Mulvany, FHFMA September 9, 2020

Looking beyond CMS: How to accelerate the transition to value in healthcare

HFMA's Chad Mulvany summarizes a blog on actions CMS and Congress can take to transition providers to capitated and other risk-bearing payment models.

Chad Mulvany, FHFMA August 24, 2020

Proposed CY 2021 Medicare Physician Fee Schedule changes: Analysis of impact on telehealth flexibilities and E/M coding

HFMA's Katie Gilfillan says the E/M coding changes taking place January 1, 2021, will have significant impacts not only to primary care physicians but also will have significant impact on specialist’s reimbursement.

Katie Gilfillan August 20, 2020

What to expect from President Trump’s recent executive orders on drug prices

HFMA's Chad Mulvany says the Most Favored Nation pricing executive order faces long odds of becoming an enforced policy because it faces significant opposition from three of the most influential lobbies in Washington, D.C.

Chad Mulvany, FHFMA August 4, 2020

Long-term fiscal impact of the of COVID-19 pandemic on the overall federal debt and Medicare Part A Trust Fund shortfall cannot be overlooked

Recommendations from healthcare economists for savings to preserve Part A Trust Fund focus more on taxes and less on providers.

Chad Mulvany, FHFMA June 19, 2020

House bill may provide insight into coverage priorities if White House and Senate flip in November’s election

The best-case scenario for Democrats is to come out of election night with a 50-50 split of the Senate, which would allow them to pass a package of tweaks to the ACA, with the Vice-President (assuming Biden wins) casting the deciding vote.

Chad Mulvany, FHFMA June 18, 2020

Intermountain Healthcare to provide hospital-at-home services for some higher-acuity patients

The move to hospital at home for higher-acuity patients by some health systems can create savings for their Medicare Advantage and other full risk products and for its Administrative Services Only clients.

Chad Mulvany, FHFMA June 17, 2020
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