Analysis: New HELP draft surprise-bill legislation bases payments on geographic median rate
Recent changes to the HELP draft surprise-bill legislation indicate there is unity in Congress around calculating payments to providers for out-of-network services, but challenges to the geographic-median approach are on the horizon.
Analysis: Price check in the EHR
Humana may be a more desirable partner for physicians interested in risk arrangements if its collaboration with Epic reduces potentially preventable ED and inpatient utilization due to increased medication adherence.
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…
Timing, details unclear for executive order on price transparency
An expected executive order on healthcare price transparency continues to change, even as its release has been delayed, say policy watchers.
Inconsistent address data could delay Medicare payments
One health system found in its Medicare enrollment system that addresses were missing for new facilities. Another found addresses still listed for a demolished facility.
Activity-Based Costing: When to Walk and When to Run
A modified approach to activity-based costing can balance an organization’s desire for operational excellence with its need for repeatable, low-maintenance solutions.
Bundle up: Developments in BPCI Advanced
Rich Daly interviews Michael Wolford, a senior manager at DHG Healthcare, about the early results of Bundled Payments for Care Improvement Advanced. Also, five reasons why health systems will need advanced cost accounting in a segment sponsored by Strata Decision Technology.
Analysis: Disruption possible if negotiated rates are publicly posted
What can be expected if President Trump releases an executive order to mandate the disclosure of prices in the healthcare industry.
Analysis: Another week, another draft surprise bill legislative proposal
HFMA’s Chad Mulvany reviews why the Health, Education, Labor and Pensions committee’s cost-reduction bill released last week misses an opportunity to accelerate the spread of Alternative Payment Models.
Analysis: How private purchasers can help control healthcare costs
HFMA’s Chad Mulvany reviews results of a recent West Health and Gallup Poll survey of public opinion related to healthcare costs.