Medicare Advantage concepts come to Medicare fee-for-service with Geographic Direct Contracting Model
While the MA Stars Rating program is a bonus program where plans can earn additional revenue for achieving high scores, quality in the Geographic Direct Contracting program is treated more like a penalty, says HFMA's Chad Mulvany.
3 ways hospitals need to pivot their OR strategy in the wake of COVID-19
To maintain OR procedural revenue in the years following COVID-19, hospitals and health systems require a new surgical services strategy led by physicians and characterized by a focus on ambulatory care, with a strong emphasis on improving the patient experience and overall OR process efficiency.
CMS unveils the Geographic Direct Contracting model
The Geographic Direct Contracting model will test full-risk arrangements for healthcare entities serving thousands of Medicare beneficiaries within defined geographic areas.
Medicare phases out the inpatient-only list, backs off further 340B payment cuts
The final rule for the CY21 Medicare Outpatient Prospective Payment System will phase out the inpatient-only list but won’t implement steeper 340B cuts.
Rand releases updated study of hospital payment variation in commercial market
HFMA's Chad Mulvany says it’s imperative that everyone in the U.S. supports safety-net hospitals, or there will be an increase in the disparities in access to basic healthcare services between the haves and have-nots.
OPPS proposed rule would eliminate ‘inpatient only’ list of procedures
The CY21 OPPS proposed rule would eliminate the inpatient-only list of services over three years while increasing the number of ASC-eligible procedures, and also would increase 340B payment cuts and overhaul the hospital star-rating system.
‘A mountain of work’: Lessons from 2 organizations that restarted elective procedures after the COVID-19 moratorium
Leaders with two provider organizations that resumed elective procedures as COVID-19 began to ebb in their markets describe the most important considerations.
Health systems may require a smaller real estate footprint post-pandemic
Although there's an opportunity to reduce facility costs and generate revenue by selling idle real estate as a result of telework and virtual care delivery post-pandemic, the transition to virtual visits may have a negative impact on provider revenue that exceeds the savings.
Telehealth’s impact on clinic staffing models post-COVID-19
HFMA's Chad Mulvany predicts that if COVID-19 leads to widespread usage of telehealth, post-pandemic it will lead to a rethinking of primary care clinic footprints and staffing models.
Analysis: Private equity interest in orthopedics increases
Demographics and payment policy are the main drivers of the surge in private equity deals involving orthopedics practices in 2019.