Payment Reimbursement and Managed Care

3 essentials for creating and managing a high-value PAC Network

A health system's ability to succeed under value-based payment depends on its having a well- developed post-acute care strategy.

Chad Mulvany, FHFMA August 2, 2019

Analysis: 6 strategies of successful ACOs revealed in OIG study

The six strategies used by successful accountable care organizations are discussed in a review of a study of successful ACOs, released by the Office of the Inspector General last week.

Chad Mulvany, FHFMA August 1, 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

Provider Risk Readiness Report

The results of a May 2019 HFMA study about risk readiness in which hospital and health system senior financial leaders share insights on their organizations’ risk capabilities and tolerance.

HFMA August 1, 2019

Why the call for price transparency is a call for innovation

To navigate and respond to the murky issue of price transparency, hospitals and health systems must innovate.

Jeff Helton,  PHD, FHFMA, CMA, CFE August 1, 2019

Price transparency: A new chapter begins

HFMA President and CEO Joe Fifer offers a perspective on the executive order on price transparency.

Joseph J. Fifer, FHFMA, CPA August 1, 2019

The price of precision medicine: 3 ways for health plans to manage genetic-testing costs

With spending on genetic testing expected to grow significantly, health plans can use three steps to get a handle on costs.

Emad Rizk, MD 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
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