Executive Summary: Final 2018 OPPS/ASC Rule
This document provides a brief summary of key financial and operational impacts from the 2018 outpatient prospective payment system (OPPS) final rule.
Trend Toward Increasing Payer Deductions Continues
Payer deductions continue to increase, with government payers far exceeding private and managed care plans.
Understanding the Problem of Claim Processing Waste
Even small improvements in connectivity and transparency could save a few dollars per healthcare claim, which adds up very quickly.
Targeted Care Integration Can Help Drive Success Under Risk Contracts
Providers can avoid many of the missed opportunities associated with risk contracts by carefully reviewing the targeted patient population, narrowing the number of performance metrics, and selecting the right clinicians to participate.
CMS Proposal: A Path to an Uncertain Future for 340B
CMS’s proposal to reduce rates for 340B-covered entities for separately payable outpatient drugs may indicate the Trump administration may take an aggressive approach to healthcare policy.
Optimizing Financial Performance Under Value-Based Care
As they seek to adapt their organizations to the demands of value-based care, physician leaders can follow the example of participants in the Oncology Care Model.
HFMA Comments on the CY18 OPPS/ASC Proposed Rule
HFMA submitted comments to CMS on the CY 2018 OPPS/ASC proposed rule.
Three Strikes Against the Idea that Coverage Reduces ED Use
Ken Perez describes three case studies showing that expanded coverage increases emergency department use.
Improve Compliance and Revenue by Understanding the Two-Midnight Rule
Edward Hu, MD, president of the American College of Physician Colleges, offers guidance for physicians seeking to better understand the two-midnight rule.
FY18 IPPS Final Rule Summary
This document summarizes the FY18 IPPS final rule, published by CMS.