States look to Medicare-based reference pricing as the solution to price variation for employee hospital services
To reduce prices paid for hospital services delivered to their employees, Montana and North Carolina are pursuing reference pricing based on Medicare rates.
HOPDs vs. ASC: Understanding Payment Differences
The growth of ambulatory surgery centers has hospitals and health systems looking at payment in a new way.
Montana’s dive into Medicare reference pricing reduces provider payments by almost $16 million annually
Montana’s adoption of Medicare reference pricing has dramatically reduced payment rates for healthcare services delivered to state employees.
3 ways to remove the mystery from value-based payments
Daniel M. Grauman and Amanda Brown explain how analytic tools can assist a healthcare organization in identifying areas for improvement in value-based payments.
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.
Making sense of Trump’s 2020 budget proposals for healthcare
Congress is almost certain not to accept president Trump’s proposed budget for FY20 with its cuts to Medicare and Medicaid, but he is not the first president to propose a budget that has little chance of being accepted.
Democrats Decry Trump Administration’s Court Support for ACA Rollback
A day after the Trump administration in court backed full repeal of the Affordable Care Act, members of Congress warned about potential impacts on public and private insurance coverage.
HFMA Offers Recommendations to Senate to Reduce Total Cost of Care while Improving Patient Outcomes
This letter contains HFMA's recommendations to the Senate HELP committee on ways to reduce the total cost of care while improving patient outcomes.
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.
HHS Notice of Benefit and Payment Parameters for 2020 Proposed Rule Summary
Summary of the Notice of Benefit and Payment Parameters for 2020 proposed rule, published by CMS.