The Controversy over the Rules of the Game for the Medicare Shared Savings Program
Ken Perez examines the fundamental disagreement over how MSSP ACO savings are being measured and the potential fallout as participants consider leaving the program.
Medicare Shared Savings Program “Pathways to Success” Proposed Rule
This document summarizes the Medicare Shared Savings Program - Pathways to Success proposed rule, published in the August 17, 2018, Federal Register.
HFMA Comments on the CY 2019 OPPS/ASC Propsed Rule
HFMA submits comments to CMS on the CY 2019 hospital OPPS/ASC proposed rule, published in the July 31, 2018, Federal Register.
Rural Hospitals Push Congress to Address Key Financial Issue
Sept. 26—Amid rising concern in Congress over rural hospital failures, some stakeholders are renewing their push for a long-sought Medicare payment change that was described during a recent hearing as “one of the single most important” financial fixes for those organizations.
Site-Neutral Payment Reduction Leads Hospital OPPS Concerns
Sept. 25—Among reactions to a range of thorny policy proposals, hospital advocates are urging Medicare to withdraw a $760 million payment cut for outpatient services.
CY 2019 OPPS/ASC Proposed Rule: HFMA Executive Summary|HFMA
CMS published a proposed rule updating OPPS/ASC payments for CY 2019, in the July 31, 2018, Federal Register.
Hospitals Express Opposition to E/M Code Changes
Sept. 12—A Medicare proposal to simplify evaluation and management (E/M) codes could hit hospitals’ bottom lines, hospital advocates recently warned the Trump administration.
HFMA Comments on the CY 2019 Physician Fee Schedule Proposed Rule
HFMA submits comments to CMS on the CY 2019 Medicare Physician Fee Schedule Proposed Rule, published in the July 27, 2018, Federal Register.
Why Fee-For-Service Remains Prominent
Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.
How to Really Know Your Payment Rates
A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.