Payment Reimbursement and Managed Care

Analysis: Hospital at home will move inpatient admissions into the home

Acute care providers must analyze the risks and opportunities of participating in the at-home-hospital model of patient care.

Chad Mulvany, FHFMA November 20, 2019

One health system finds ‘millions’ of reasons to audit value-based payments

A health system identified millions of dollars in underpayments that it should have received as part of two value-based payment arrangements in recent years.

Rich Daly November 19, 2019

How one ACO leveraged universal truths of value-based contracting for success

A finance leader of successful East-coast accountable care organization describes the key factors that have enabled the ACO to thrive under value-based payment contracts.

Eric C. Reese, PhD November 18, 2019

Administration finalizes requirement for hospitals to post rates paid by health plans

A newly finalized requirement will require hospitals to post rates that are privately negotiated with health plans, as well as rates for a list of 300 “shoppable services.”

Rich Daly November 15, 2019

White House healthcare leader expresses skepticism of mandatory models

The Trump administration’s healthcare policy leader was openly skeptical about further use of mandatory payment models after Medicare has added several in recent years.

Rich Daly November 14, 2019

Why the Trump administration is pursuing hospital payment cuts that courts have rejected

The Trump administration is continuing to push hospital payment cuts rejected by courts to make the case to Congress that new laws are needed, according to a senior White House official.

Rich Daly November 13, 2019

Analysis: Haven’s first moves: Benign or disruptive?

The rollout of Haven insurance in 2020 for the 1.2 million combined employees of Amazon, JPMorgan Chase and Berkshire Hathaway should not be dismissed by other industry players.

Chad Mulvany, FHFMA November 12, 2019

Federal policy drives hospital-practice deals but not M&A between hospitals, MedPAC finds

Federal policy is not driving hospital M&A but is encouraging hospital purchases of practices, a key congressional advisory group said.

Rich Daly November 12, 2019

6 key opportunities to optimize revenue with strategic pricing

Strata Decision Technology breaks down how providers can set defensible, geographically-sensitive prices that can be made visible to consumers without concern of backlash.

Strata Decision Technology November 11, 2019

Transparency rule could come this month, White House executive says

A controversial requirement for hospitals to publicly post the rates they negotiate with health plans is expected this month, according to a senior White House official.

Rich Daly November 8, 2019
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