Medicaid Payment and Reimbursement

Annual Hospital Costs for Opioid Overdose Patients Approaches $2 Billion

The average cost for an overdose patient who was treated and released totaled $504, but the average cost rose to $11,731 for those that were treated and admitted to a hospital.

HFMA February 15, 2019

Jan. 21-25: Medicaid Policies in Focus

Jan. 17—As Congress’s primary Medicaid advisory body prepares to meet next week, hospitals and insurers are clashing over changes to the program’s managed care rules.

Rich Daly January 17, 2019

Ask the Experts: Data for Health Plan Negotiations

What data do I need to arm myself with when going to the negotiation table with health plans?

HFMA November 26, 2018

Providers Should Keep Watch on Payer Discount Increases

A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.

Jeanne M. Slates November 2, 2018

What Changes Are Coming to Medicaid in 2019?

Oct. 16—Additional state expansions of Medicaid eligibility are among the expected developments coming next year to the program, according to a former federal leader of Medicaid.

Rich Daly October 18, 2018

Keeping Up-To-Date on Shifting Medicaid Eligibility Laws

A government affairs expert shares strategies for keeping up with complex Medicaid rules and stay in compliance.

Marie Hinds October 4, 2018

Getting Proactive About Bundles

Building on lessons learned from early bundle experiences, a midwestern health system is proactively designing its own bundles as it works with insurers and the state to craft bundles that better represent clinical and operational realities.

Anne Stockton September 26, 2018

Medicaid Plans, Hospitals Clash over Proposed Kids Model

Sept. 5—Medicaid insurance companies and hospitals squared off in Congress this week over legislation to expand children’s medical homes nationally.

Rich Daly September 6, 2018

Why Fee-For-Service Remains Prominent

Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.

HFMA August 14, 2018

How to Really Know Your Payment Rates

A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.

Debra Ryan August 13, 2018
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