Payment Reimbursement and Managed Care

Ensuring value-based data sharing complies with HIPAA

Healthcare organizations engaging in value-based contracts may be at greater risk for a breach if patient privacy and HIPAA are not front and center.

Lisa A. Eramo June 17, 2019

Remaining nimble amid government regulation changes

By being proactive and developing the capacity to change, your revenue cycle department can acquire the dynamism to respond as the Medicaid landscape shifts.

Marie Hinds June 17, 2019

6 revenue cycle objectives for the transition to value-based payment models

To maximize revenue, medical practices are focusing on value — delivering high-quality care while managing total costs — and managing risks associated with two-sided payment models.

Parag Shah June 17, 2019

Analysis: Local purchasing alliance reduces hospital prices by 20%

As more data on price variability in healthcare becomes available, there will be an increase in activist employers and employer coalitions getting local health systems to lower prices.

Chad Mulvany, FHFMA June 13, 2019

Analysis: Employers are not a monolithic block on Medicare for All

If struggles to control healthcare costs continue, more U.S. employers may change their positions in favor of Medicare for All.

Chad Mulvany, FHFMA June 13, 2019

Get creative with technology to drive your managed care programs

Technological innovations can help healthcare organizations improve their managed care programs.

David Bernd June 11, 2019

Ask the Experts: SSI percentage and eligibility

Rolling averages are one way to benchmark patient SSI eligibility percentages.

HFMA June 11, 2019

Ask the Experts: Contract performance

My organization recently transitioned to its first Ambulatory Payment Classifications (APC)/DRG-based contract with a commercial plan. We are struggling with determining how to monitor the contract’s performance and, in particular, with the primary focus on the APC payment. Are there recommended key performance indicators (KPIs) used to track this performance?  Answer: It is likely that your organization…

HFMA June 11, 2019

Analysis: Movement seen on overdue Medicare Discharge Planning Rule

The Medicare Discharge Planning Rule, which was sent to the Office of Management and Budget last week, would require hospitals to provide patients with data to help guide their selection of a post-acute care provider.

Chad Mulvany, FHFMA May 31, 2019

Analysis: 4 significant findings from the recent AMGA Physician Risk Survey

HFMA’s Chad Mulvany discusses four findings from the latest AMGA Physician Risk Survey about the transition to alternative payment models and risk.

Chad Mulvany, FHFMA May 30, 2019
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