Payment Reimbursement and Managed Care

In response to a congressional RFI, provider advocates give input on ways to bolster rural healthcare

Hospital and physician groups were among the respondents to a request by a key congressional committee for information on improving rural healthcare. In an RFI issued in September, the House Ways and Means Committee sought policy solutions for augmenting access to — and the quality of — healthcare in relatively remote areas. “The committee will…

Nick Hut October 19, 2023

CY 2024 Physician Fee Schedule Proposed Rule Summary – Part I

HFMA presents part I of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies.

HFMA October 19, 2023

HHS: Insurers won’t be penalized if they don’t update their No Surprises Act qualifying payment amounts as required

Providers may not immediately benefit from a favorable court ruling that affects the methodology for determining the qualifying payment amount (QPA) under the No Surprises Act. The U.S. Department of Health and Human Services (HHS) issued guidance Oct. 6 that says the Biden administration will not enforce the court decision until at least May 1.…

Nick Hut October 9, 2023

Insights on population health management challenges through the eyes of C-suite leaders

Population health management is at a crossroads, and one key to ensuring its viability is to bolster stakeholder trust in the potential of value-based payment (VBP) models. That was a key takeaway from healthcare executives who took part in a September panel discussion at the 23rd annual Population Health Colloquium, hosted by the Jefferson College…

Nick Hut October 5, 2023

Medicaid DSH payment cut barely averted as House, Senate pass short-term federal funding

Hospitals received a last-day reprieve from substantial cuts to Medicaid disproportionate share hospital (DSH) payments, with House leaders reversing course Sept. 30 and ushering through a six-week government funding package. Language in the bill ensures a four-year, $32 billion Medicaid DSH cut will not take effect before Nov. 17. Most importantly, the bill bought time…

Nick Hut October 4, 2023

Update: Medicaid DSH payment cut averted as House, Senate pass short-term federal funding

Note: The headline and lead section of this article were updated Oct. 1 with news of a six-week government funding extension that delays the Medicaid DSH cuts and pays for other healthcare programs. The article originally was published Sept. 28 under the headline, “An $8 billion Medicaid DSH cut is closer to happening as a…

Nick Hut October 1, 2023

Risky business: What every CFO should know before taking on risk

As a health system leader, how can you ensure your organization is making the right moves to take on risk in an evolving landscape for payment? Check out a handful of key capabilities to focus on in this article.

HFMA September 29, 2023

PFC USA’s partnership approach ensures healthcare clients tackle regulatory and patient satisfaction issues

Review some tips from a company with 6.5 years of hands-on experience in helping its healthcare clients handle concerns in healthcare such as workforce shortages and a volatile regulatory environment.

HFMA September 29, 2023

HFMA Comments on CY 2024 OPPS/ASC Proposed Rule

HFMA presents its comment letter to CMS on the CY 2024 OPPS/ASC Proposed Rule.

HFMA September 26, 2023

CMS pressures states to restore Medicaid coverage for some beneficiaries who have been disenrolled

CMS says a recent edict to state Medicaid programs has partially stanched the ongoing wave of disenrollments in the program, with about 500,000 beneficiaries set to regain coverage they had lost and “many” others protected from disenrollment going forward. As described in a Sept. 21 summary, 29 states plus Washington, D.C., have acknowledged a systemic…

Nick Hut September 25, 2023
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