Medicare Payment and Reimbursement

Analysis: Moving joint replacement procedures to the outpatient setting

A review of the potential margin impact on providers from the continued shift of high-volume, high-margin joint replacement procedures to the outpatient setting.

Chad Mulvany, FHFMA August 6, 2019

12 details to know about the IPPS final rule

CMS issued a final rule for Medicare hospital IPPS payments in FY20.

Rich Daly August 6, 2019

Single-payer concept for U.S. healthcare requires close fiscal scrutiny

The concept of "Medicare for All" has been a focus of much debate leading up to the 2020 presidential election, and the likely cost of such a program is an important factor that needs to be considered.

Ken Perez August 2, 2019

Why hospital outpatient physical therapy is a good revenue source I HFMA

It makes good business sense for health systems to make outpatient physical therapy a priority given the payment landscape for such services and the value they can provide.

John Britt August 2, 2019

Aug. 5-9: See what events are coming in healthcare

Stay ahead of healthcare news and developments with this listing of hearings, conferences, webinars, public forums and deadlines for the week of Aug. 5.

Rich Daly August 1, 2019

A look at early hospital concerns over the proposed release of negotiated charges

National hospital advocates, individual executives and an industry adviser identified early concerns with the proposed mandatory release of hospital-negotiated charges.

Rich Daly July 31, 2019

OPPS rule to bring many hospital financial challenges — and a little help

The long-awaited Medicare proposed rule for hospital outpatient payments includes a high-profile mandate on hospitals to release rates negotiated with commercial health plans, among other regulations that could pose financial challenges. Several smaller provisions could help hospitals.

Rich Daly July 31, 2019

Slow expansion of SDOH benefits expected in 2020 MA health plans

MA health plans are expected to incrementally increase in 2020 their use of programs targeting the social determinants of health.

Rich Daly July 29, 2019

Verma points to hospitals as the largest driver of healthcare costs

The Trump administration’s Medicare leader singled out hospitals as the leading driver of healthcare cost increases.

Rich Daly July 25, 2019

‘Medicare for All’ to cost hospitals $200 billion annually, analysis finds

Although a slice of hospitals might financially benefit from a single-payer model based on Medicare rates, 90% would face cuts totaling $200 billion each year, according to a new industry analysis.

Rich Daly July 24, 2019
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