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.
Aug. 13-17: Senate to Vote on HHS Funding
Aug. 10—The U.S. Department of Health and Human Services (HHS) would receive a small increase and funding for several hospital priorities under a FY19 funding bill that the Senate is expected to vote on next week.
IPPS Rule Includes Pay Bump, Reporting Simplification
Aug. 6—More than 3,000 hospitals will receive an average increase of nearly 3 percent in their Medicare inpatient payment rates—along with a slew of policy changes—under a recently issued final rule.
Medicare Offers $1 Billion Increase, Policy Changes for Post-Acute Providers
Aug. 1—Post-acute care providers will see more than a $1 billion pay boost for FY19—along with a range of policy changes—as described in annual final rules issued by Medicare this week.
Medicare Proposes $760 Million 2019 Hospital Cut
July 27—A range of major hospital policy changes includes a $760 million cut as part of the 2019 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.
Number of MSSP ACOs and Shared-Savings Characteristics
The number of ACOs participating in the Medicare Shared Savings Program increased at a faster rate from 2013 to 2018 than did the number of participants that achieved shared savings in the first four years of the program.
Medicare Advantage for More: A Pragmatic Alternative to Medicare for All
An expansion of Medicare Advantage presents an opportunity for the U.S. to test the waters of a single-payer system.
CY2019 Medicare End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule: HFMA Executive Summary
CMS published a proposed rule updating payment rates under the Medicare End-Stage Renal Disease prospective payment system for CY2019, in the July 19, 2018, Federal Register.
CY2019 Home Health Prospective Payment System Proposed Rule: HFMA Executive Summary
This document summarizes the proposed rule updating payment rates under the home health PPS for CY2019, published by CMS.