Hospital revenue is enhanced by state-directed Medicaid payments, health systems report
State-directed supplemental payments made through Medicaid are a growing source of hospital revenue, according to financial reporting from the for-profit hospital sector. In reporting their Q2 financials, several of the nation’s largest health systems cited Medicaid supplemental payments as a boost. State-directed payments are a relatively new form of those payments, applying to Medicaid managed…
Navigating toward successful contract negotiations with health plans
A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.
The Medicaid unwinding continues to pose issues one year in, but healthcare coverage appears stable
The unwinding of Medicaid continuous-enrollment requirements reached the one-year mark this month amid mixed measures of the effect on overall coverage. In one sense, the impact has exceeded all projections. Since states could begin disenrolling Medicaid beneficiaries on April 1, 2023, coverage for more than 19.6 million beneficiaries had been terminated as of April 4,…
Highlights of the Administration’s FY 2025 Budget
HFMA presents a summary highlighting healthcare-related proposals included in the President’s Budget for fiscal year 2025, based on materials released by the Biden Administration on March 11, 2024.
Definition of “Employer”—Association Health Plans Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule published by the Employee Benefits Security Administration that would rescind the similarly titled rule finalized in 2018 (83 FR 28912) that expanded the regulatory definition of “employer” under the Employee Retirement Income Security Act of 1974.
HFMA Comments on Federal Independent Dispute Resolution Operations, Proposed Rule
HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Operations Proposed Rule.
HFMA Comments on Federal Independent Dispute Resolution Process Fees Proposed Rule
HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Process Fees Proposed Rule.
Medicaid Drug Misclassification Proposed Rule Summary
The rule proposes to implement policies in the Medicaid Drug Rebate Program (MDRP) related to legislative requirements addressing drug misclassification, as well as drug pricing and product data misreporting by manufacturers.
Ensuring Access to Medicaid Services Proposed Rule Summary
On May 3, 2023, CMS published in the Federal Register a proposed rule entitled “Medicaid Program; Ensuring Access to Medicaid Services” (88 FR 27960-28089). The rule proposes policies that take a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service, managed care delivery…
How managed care contracting strategies promote operational resilience
Read this article for an in depth look on several strategic steps for healthcare leaders to take to benefit their organization's managed care contracting.