Medicare Payment and Reimbursement

Why optimizing the patient experience should be on every C-suite leader’s radar

Jason Wolf, president and CEO of The Beryl Institute, knows from personal experience how easily a healthcare organization can lose a customer. A few years ago, his wife was mistakenly billed for a $25 copay that she already paid, and then the account was fast-tracked into collections. Despite receiving excellent clinical care, his wife vowed…

Laura Ramos Hegwer June 11, 2019

CMS cardiac procedure changes could cost hospital cardiac programs $700 million

In a move that could have profound financial implications for hospitals, the 2019 Outpatient Prospective Payment System final rule adds 17 cardiac procedures to the list of procedures approved by CMS to be performed in ambulatory surgery centers.

Ronald Hirsch, MD, FACP, CHCQM June 11, 2019

A caveat: A cardiac procedure performed in an ASC may cost a Medicare beneficiary more

For Medicare beneficiaries who are considering out-of-pocket costs for the cardiac services that CMS has approved to be performed in ambulatory surgery centers (ASCs), hospitals could be a more attractive site of service.

Ronald Hirsch, MD, FACP, CHCQM June 10, 2019

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.

Rich Daly June 7, 2019

Mandates related to pricing, Medicare participation lead hospital concerns over healthcare IT proposed rules

Hospitals supported many of the transparency goals of two proposed healthcare IT rules, but two areas drew sharp concerns.

Rich Daly June 5, 2019

June 2-7: See what events are coming in healthcare

Stay ahead of healthcare news and developments with this listing of hearings, conferences, webinars, public forums and deadlines for the week of June 2.

Rich Daly May 31, 2019

How a Hospital or Health System Can Assess the Risk of Moving to Value-Based Payment

To gain a clearer understanding of the financial impact of transitioning to a value-based model, healthcare executives can learn from the experiences of another health system that has undertaken a similar migration.

Ross Armstrong May 29, 2019

Part D savings plan dialed back

Part D plans will have fewer new tools to control drug spending than Medicare initially proposed.

Rich Daly May 21, 2019

Deceased Medicare beneficiary admissions: Accounting for the causes and impacts

Just over 3 percent of Medicare admissions end with the death of the patient. This finding is based on data from fiscal years 2015 through 2017 reported in the Medicare Provider Analysis and Review (MedPAR) file. As would be expected, the time and resources required to treat a beneficiary who is near death and ultimately…

HFMA May 19, 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
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