Payment Reimbursement and Managed Care

Analysis: Optum to empower its physicians via advanced analytics to improve care and coordinate referrals

Once OptumHealth links its physician network to data it gleans from its data analytics engine, referrals from Optum employed and aligned providers will move from high-cost providers to lower-cost, more conservative ones.

Chad Mulvany, FHFMA September 9, 2019

Analysis: Health plans, physician practices align to manage population health and reduce total cost of care

A discussion of strategies health plans are deploying to align with physicians, manage referrals, improve outcomes and reduce the total cost of care as the U.S. healthcare system transitions to population health-based payment models.

Chad Mulvany, FHFMA September 9, 2019

Sept. 9-13: Senate committee to vote on HHS funding

Senate appropriators will vote on funding for the U.S. Department of Health and Human Services, among other key healthcare finance events around the country next week.

Rich Daly September 6, 2019

The Hospital Impact of the “Public Charge” Immigrant Rule

Rich Daly and Chad Mulvany discuss the impact of the "public charge" rule on hospitals. Jim Zadoorian of ARXchange talks about a new approach to price transparency. Also, Strata Decision Technology provides five ways healthcare organizations can prepare for the future with strategic planning.

Erika Grotto September 5, 2019

New payment and service delivery models defined

A brief outline of new payment and service delivery models launched by the Centers for Medicare & Medicaid Services

Theresa Hush August 31, 2019

Providers explore new territory with health plan ownership

Health systems are showing renewed interest in forming provider-sponsored health plans for a number of reasons, including rising enrollment in Medicare Advantage plans and discontent with payer-provider partnerships.

Kai Tsai August 31, 2019

What to know before rolling out a PSHP

Healthcare organizations that are launching a provider-sponsored health plan should consider four recommendations.

HFMA August 31, 2019

Ontario Systems: Helping Healthcare Organizations Realize the Benefits of an Accountable Collections Team

Steve Scibetta, vice president and general manager at Ontario Systems, offers strategies for optimizing the revenue cycle, including employing supportive accounts receivable technology and building an accountable collections team.

HFMA August 31, 2019

BLS|Revecore: Technology-Driven Underpayment Review Services

In this article, BLS|Revecore talks about how its underpayment review technology and deep industry expertise help organizations collect dollars that would otherwise go unrecovered.

HFMA August 31, 2019

Navigant Consulting, Inc.: Hospitals and Health Systems Prepare to Assume More Risk

: This research highlight discusses key takeaways from a May 2019 HFMA study of hospital and health system senior financial executives about their organizations’ interest in and capabilities for assuming risk.

HFMA August 31, 2019
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