Health Plan Payment and Reimbursement

As states tweak Medicaid programs, enrollment increases fall far short of job losses

Medicaid enrollment increases have lagged far behind unemployment increases but are still pressuring states facing a budget squeeze during the recession.

Rich Daly September 14, 2020

Business Group on Health’s Annual Survey: Large employers ready to take the reins on healthcare cost

Responses to the Business Group on Health's annual survey of its large employer members suggest employers are tired of waiting for providers and plans to figure out how to reduce healthcare cost.

Chad Mulvany, FHFMA September 11, 2020

Despite the pandemic, hospitals continue to shift toward value-based payment

Hospitals plan to continue moving to value-based payment despite obstacles to caring for patients under risk-based contracts amid the COVID-19 pandemic.

Rich Daly September 10, 2020

Commercial health plans’ value-pay response to pandemic mixed, say providers

Commercial health plans have offered providers in value-based payments some pandemic-related flexibilities but rejected some changes.

Rich Daly August 28, 2020

Telehealth helped chronically ill during pandemic but their access to care worsened: CDC

Many chronically ill sought telehealth care during the pandemic, even as they reported worse care access, according to a CDC survey.

Rich Daly August 27, 2020

Looking beyond CMS: How to accelerate the transition to value in healthcare

HFMA's Chad Mulvany summarizes a blog on actions CMS and Congress can take to transition providers to capitated and other risk-bearing payment models.

Chad Mulvany, FHFMA August 24, 2020

Employers pivot from value-based payment to virtual care amid the pandemic

Employer-sponsored health plans are pausing value-pay expansions in favor of adding virtual care options in response to the COVID-19 pandemic, according to a business group survey..

Rich Daly August 19, 2020

Hospitals with health plans have gotten a financial boost during the pandemic

Hospitals with provider-sponsored health plans have obtained a financial cushion to offset the steep losses from the coronavirus pandemic on the provider side.

Rich Daly July 24, 2020

As the COVID-19 situation improves in Maryland, hospitals not immune to losses

Maryland hospitals suffered COVID-19 volume losses, but they say the state’s unique all-payer rate-setting system mitigated the situation to a degree.

Rich Daly July 23, 2020

Regional differences emerge in hospital volume recovery from COVID-19

Hospitals in the Mid-Atlantic have struggled the most to recover outpatient volumes as patient fears linger in the wake of the COVID-19 pandemic.

Rich Daly July 16, 2020
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );