Payment Reimbursement and Managed Care

Addressing the largest area of healthcare waste requires plans and providers to collaborate

Plans and providers should work together to systematically catalog the biggest administrative complexities responsible for unnecessary healthcare spending and develop a standardized approach to reduce or eliminate them.

Chad Mulvany, FHFMA October 16, 2019

Analysis: Initial thoughts on the President’s recent Medicare executive order

A review and insight on several key points in the President’s Medicare executive order issued Oct. 3.

Chad Mulvany, FHFMA October 9, 2019

Direct contracting models offer promise of expedited shift to value-based care

CMS’s Direct Contracting Models offer providers some substantial benefits, including access to capitation payments for Medicare fee-for-service members — without the investment costs in brokers and marketing to move members into Medicare Advantage.

Allen Miller, MPH October 5, 2019

Analysis: How a longer-term delay to Medicaid DSH cuts may play out

A review of CMS’s recent rule finalizing the ACA’s mandated Medicaid DSH cuts for FY2020 and how it may play out if some legislators demand changes to the rule.

Chad Mulvany, FHFMA October 3, 2019

Analysis: Wage index changes in the IPPS Final Rule

A review of why a couple of the key changes to the CMS FY2020 IPPS Rule may not bring the desired results.

Chad Mulvany, FHFMA October 2, 2019

Analysis: CMS final discharge planning rule

A review of the final rule and suggestions for related HFMA resources.

Chad Mulvany, FHFMA October 2, 2019

Analysis: Tennessee proposes an overhaul to funding of its Medicaid program

HFMA's Chad Mulvany reviews Tennessee’s proposal to overhaul funding of its Medicaid program and shares why CMS is likely to reject it.

Chad Mulvany, FHFMA September 30, 2019

Analysis: Site-neutral payment ruling favors hospitals for now

A Sept. 17 ruling by a U.S. District Judge favored hospitals by overturning the CMS rule that cut Medicare payments for E&M visits in certain hospital-based settings.

Chad Mulvany, FHFMA September 24, 2019

Analysis: Employers have a healthcare cost growth problem

A discussion on the unsustainable growth rate of employer-sponsored health benefits and how industry participants can help them.

Chad Mulvany, FHFMA September 17, 2019

Making price transparency easy for patients

Proactive providers are preparing for additional price transparency requirements to ensure they not only comply with government regulations, but also provide patients with enough information to make informed healthcare decisions.

Rebecca A. Marsh September 13, 2019
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