Accounting for Non-Performance-Related Variation in Shared Savings Contracts
Variation between targeted and actual PMPM costs can be due to numerous factors, including many that have nothing to do with the quality or cost of care provided to ACO members.
Six Ways to Address Non-Performance-Related Variation in ACO Contracts
While not yet a perfect science, payers and providers can begin to address non-performance-related variation in a number of ways.
What Does Financial Success Look Like in the CAH World?
CFO Bryce K. Betke credits four key factors for Crete Area Medical Center’s success: affiliation, payer mix, physician employment, and population health.
The Physician Value-Based Payment Modifier: Summary of National Provider Call
Beginning in 2015, physicians will be financially rewarded by Medicare for providing higher-quality, more efficient care. Here’s what CMS told providers about the payment adjustment during a Dec. 3 call.
Highlights from Nov. 12 Open Door Forum on 2-Midnight Rule
On Nov. 12, 2013, CMS hosted a third, follow-up special open door forum to allow providers and other interested parties to ask questions on those areas of the two-midnight provision contained in the FY14 IPPS final rule, pertaining to physician order and certification, inpatient hospital admission, and medical review criteria.
Double Checking Your Medicare Cost Report
Here are seven issues that need to be correct on your cost report to ensure appropriate Medicare payments.
Learnings from the Front Lines: Physician Co-Management at Columbus Regional Health
Given the success of its surgical co-management program and employee gainsharing arrangement, the health system is considering a similar program for the ED and is positioning the organization to take on risk-based contracts.
At a Glance: What the Final Health Insurance Exchange Navigator Rule Means for Providers
Can hospitals and health systems serve as navigators or other assisters for the health insurance marketplaces? Here’s what the CMS final rule has to say.
When and How ERISA Can Protect Providers in an Audit Situation
Here are some specifics providers should know about ERISA and commercial audits.
HIPAA and Cloud Computing
Cloud computing multiplies the compliance risks for healthcare organizations, which possess both protected health information and financial information.