Payment Reimbursement and Managed Care

Analysis: Timeline for CMS’s mandatory radiation oncology model appears to slip

It’s not surprising CMMI has slowed its pace on finalizing the proposed mandatory radiation oncology payment model given the complexity of the model and stakeholder opposition.

Chad Mulvany, FHFMA December 11, 2019

Analysis: More options for providers looking to directly contract with employers for episodes of care

Platforms like Carrum Health’s are meeting the demands of employers for higher-value care and the providers who want to meet these demands.

Chad Mulvany, FHFMA December 10, 2019

Analysis: What healthcare providers need to know about short-term limited-duration health insurance products going into 2020

Healthcare providers need to be aware they will likely encounter an increase in the number of patients who have purchased short-term health insurance, with its limited benefits, that will be available on the healthcare exchange in 2020.

Chad Mulvany, FHFMA November 26, 2019

Take this job and shove it: 2 PTAC members quit in frustration over CMMI opposition to committee recommendations

The result of CMMI’s reluctance to accept recommendations from the field is one of many factors that stymies the transition to value.

Chad Mulvany, FHFMA November 26, 2019

Analysis: ‘Medicare for All’ supporters more concerned about cost

New survey results: Those that favor Medicare for All are more dissatisfied with the cost of healthcare and concerned about paying for care if they became ill.

Chad Mulvany, FHFMA November 7, 2019

How to make annual price reviews as easy as paying your bills

Sponsored content: Healthcare organizations seeking to stay on top of new price transparency regulations should use a strategic pricing model to ensure their prices are in line with those of their market.

HFMA November 5, 2019

Analysis: 2018 Medicare ACO results: Promising but not sufficient

A review of CMS’s recently released 2018 MSSP prompts HFMA’s Chad Mulvany to suggest as a society, the U.S. needs find additional ways to close the deficit between our means to pay for federal healthcare programs and what these programs cost.

Chad Mulvany, FHFMA November 5, 2019

Administrative prior authorization requirements increasingly used to steer patients to lower-cost settings

Hospital finances could be significantly impacted by UnitedHealthcare’s expansion of site-of-service prior authorization requirements going into effect Nov. 1.

Chad Mulvany, FHFMA November 5, 2019

Analysis: What to expect after the Texas vs. Azar ruling

There’s still much to be argued and dealt with regarding Texas versus Azar, and no final decision on the ACA should be expected until June 2020 at the earliest.

Chad Mulvany, FHFMA November 5, 2019

Healthcare reform moves to the states: Strategies to increase access and control costs

An increasing number of states are looking to improve access and reduce costs by funneling innovations, such as a public option or reinsurance program, through Medicaid.

Pam Nicholson, MBA November 5, 2019
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