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.
Creating Value in the Medicaid Expansion: A Strategic Framework for AMCs
Academic medical centers that work with states to find mutually beneficial Medicaid strategies may find themselves well positioned in an era of value.
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.
HFMA Comments on CY18 Physician Fee Schedule Proposed Rule
HFMA commented on CMS’s CY 2018 Physician Fee Schedule 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.
How CMS Leveled the Playing Field for Hospital Readmission Penalties
A new rule finalized by CMS acknowledges that charging hospitals with higher percentages of dual eligibles the same readmission penalties as hospitals with fewer of these patients. The proposed penalty adjustment will reflect the challenges facing each hospital's populations.
Evidence-based Guidelines Can Lead ACOs Toward MACRA Success
Joe Guerriero describes opportunities for ACOs enrolled in Medicare programs.
Executive Summary: CMS 2018 IPPS Final Rule
HFMA summarizes the Centers for Medicare & Medicaid Services' 2018 Inpatient Prospective Payment System Final Rule.
Taking Control of Pay-For-Performance Contracts
To ensure their organizations perform effectively under risk contracts, healthcare finance leaders should implement a work plan to manage the contracts.
10 Critical Medicaid Trends to Watch
It is important for hospitals and health systems to forecast the impact of proposed healthcare legislation on Medicaid payments, eligibility teams, and patients.