Payment Reimbursement and Managed Care

Safety net hospitals could see increase in payments if CMS updates estimates of uninsured in 2021 IPPS final rule

HFMA's Chad Mulvany explains why a small percentage point increase in the uninsured rate could significantly impact the UC DSH dollars available to safety net hospitals at a time when they are financially struggling due to COVID-19.

Chad Mulvany, FHFMA June 8, 2020

Study: Medicare Advantage enrollees less likely than traditional Medicare enrollees to use both institutional post-acute care and home health care

HFMA's Chad Mulvany says where there is competition for PAC discharges, providers should partner with high-quality PAC providers.

Chad Mulvany, FHFMA June 2, 2020

State public option efforts waiver in face of the COVID-19 pandemic

HFMA's Chad Mulvany says although COVID-19 may have "dampened enthusiasm" for Washington state's public option, he is not sure the blame for its slow start rests solely, or even partly, on COVID-19.

Chad Mulvany, FHFMA May 28, 2020

Medicaid provider rate cuts forecast as states anticipate budget shortfalls

Because the CARES Act prohibits states that received increased funding from cutting benefits, increasing premiums or restricting eligibility, one of the few available options to reduce costs is making provider rate cuts.

Chad Mulvany, FHFMA May 27, 2020

CMS seeks healthcare provider comments on possible new methodology to calculate MS-DRG weights

HFMA's Chad Mulvany reviews possible technical and legal challenges CMS may face as it proposes to collect provider pricing data.

Chad Mulvany, FHFMA May 19, 2020

Key hospital provisions and some questions requiring resolution from the CARES Act

Summary of the top five CARES Act provisions impacting hospital finances and the open questions associated with those provisions.

Chad Mulvany, FHFMA April 2, 2020

Will the value-based movement be re-energized in the wake of the coronavirus pandemic and its impact on national health expenditure?

HFMA's Chad Mulvany says he hopes healthcare payers and providers will be able to use the coronavirus crisis and the resulting impact on the national health expenditure as a catalyst to revive the value-based movement.

Chad Mulvany, FHFMA April 2, 2020

Risk-based contracting in the time of coronavirus

The APM target prices/benchmarks are among the many policy issues beyond paying for surge capacity that CMS, commercial health plans and providers will need to work through in the wake of the coronavirus outbreak.

Chad Mulvany, FHFMA April 1, 2020

State legislators roll back Indiana hospital bill that could have cut payments to hospitals

Health plans seeking state legislative help with site-neutral payments will likely find allies among employers who are increasingly frustrated with healthcare costs.

Chad Mulvany, FHFMA March 10, 2020

How long will employers continue to tolerate healthcare cost growth in excess of inflation?

Employer frustration with high healthcare costs is translating into support for more aggressive governmental intervention in healthcare markets.

Chad Mulvany, FHFMA March 6, 2020
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