What’s the blueprint for taking on risk?
Providers and health plans need to collaborate — both in the planning and execution of risk-based contracts — in order to make them work.
Medicare Advantage plans accelerating their move into SDOH, advocate says
Medicare health plans have increasing authority to grapple with the social determinants of health, and more are pursuing such initiatives.
Analysis: CMMI primary care initiatives: Potential opportunity but lots of questions
The five new alternative payment models offer multiple participation options for primary care practices of different sizes with advanced capabilities.
Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs
CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.
‘Medicare for All’: Do the numbers
Healthcare leaders can foster a productive debate about “Medicare for All” by driving analyses based on data such as cost projections, writes HFMA President and CEO Joseph J. Fifer.
Analysis: Another year closer to depleting the Part A Trust Fund
With the predicted depletion of Medicare’s hospital insurance fund, and Congress unlikely to increase taxes for working people or hike costs for beneficiates, what should healthcare finance leaders expect?
HFMA’s Payment Reform Project White Papers
HFMA has led a payment reform thought leadership initiative to identify the principles that should guide changes to the current healthcare payment system and the competencies that providers will need to succeed. The initiative's findings and recommendations are summarized in these white papers.
Medicare’s Move Toward Site-Neutral Payment
A payment change in the OPPS final rule that aims to align payments made for services delivered in off-campus hospital outpatient departments with those made for services delivered in physician offices has raised considerable controversy.
Time to Reassess: Keeping Up with Changes to CJR Target Pricing
Performance improvement targets have shifted again in the Comprehensive Care for Joint Replacement (CJR) program. Darcie Hurteau explains why participants should reassess their program strategies in light of this change.
4 Steps for Success in a Changing Payment Landscape
The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.