Payment Reimbursement and Managed Care

How to refine medical record sharing to mitigate risk and improve productivity

Careful review of medical record sharing costs and responsibilities stated in managed care contracts can reduce providers' expenses and productivity burden during payer reviews and audits.

Greg Ford May 28, 2019

Analysis: Comparing commercial hospital rates to Medicare is inappropriate

RAND study says hospitals treating patients with private health insurance were paid 2.4-times the Medicare rates, but Chad Mulvany says Medicare is the wrong measuring stick.

Chad Mulvany, FHFMA May 17, 2019

Analysis: UnitedHealthcare expands MA bundled payment plan offerings for 2020

HFMA’s Chad Mulvany says UnitedHealthcare’s move to expand its bundled payment offerings to providers in its Medicare Advantage plans in more than 30 states is a step in the right direction in support of providers’ efforts to transition to value-based payment models.

Chad Mulvany, FHFMA May 15, 2019

Analysis: Making smarter decisions about where to recover after hospitalization | HTML

HFMA’s Chad Mulvany looks at why the transition from acute to post-acute is one of the greatest opportunities to improve clinical outcomes, the patient/caregiver experience of care and reduce the total cost of care for older adults.

Chad Mulvany, FHFMA May 15, 2019

3 ways to remove the mystery from value-based payments

Daniel M. Grauman and Amanda Brown explain how analytic tools can assist a healthcare organization in identifying areas for improvement in value-based payments.

Daniel M. Grauman, MBA, CPA/ABV May 15, 2019

Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs

CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.

Chad Mulvany, FHFMA May 15, 2019

‘Medicare for All’: Do the numbers

Healthcare leaders can foster a productive debate about “Medicare for All” by driving analyses based on data such as cost projections, writes HFMA President and CEO Joseph J. Fifer.

Joseph J. Fifer, FHFMA, CPA May 15, 2019

Analysis: How overcoming some hurdles can help providers manage PAC spend

HFMA’s Chad Mulvany discusses how the PAC-spending results of a recent study on older patients with joint replacements could easily apply to any number of common episodes of care experienced by Medicare beneficiaries.

Chad Mulvany, FHFMA May 15, 2019

Analysis: What factors will come into play as stakeholders respond to a recent decision on Medicaid work rules

Key things to look for from all stakeholders even though the latest work requirement ruling only applies to the Kentucky and Arkansas cases.

Chad Mulvany, FHFMA May 15, 2019

Analysis: CMS looks to partner with states to expand dual-eligible care models

CMS is encouraging states to test approaches to integrating dual-eligible patients’ care to improve outcomes and reduce costs for federal and state governments.

Chad Mulvany, FHFMA May 15, 2019
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