Payment Reimbursement and Managed Care

Hospitals Targeted in Federal Cost-Saving Ideas

A bipartisan group of policy advocates urged Congress to target hospitals as part of a highly anticipated legislative push on cost control.

Rich Daly May 6, 2019

March 11-15: MedPAC Highlights Need for National ED Coding Guide

Medicare emergency department (ED) patients have gotten sicker in recent years, according to a new analysis of hospital coding trends. As a result, national ED coding guidelines may be needed, said the congressional advisory panel that conducted the analysis.

Rich Daly May 6, 2019

April 1-5: What Events Are Coming in Health Care

Next week’s healthcare finance events and developments include the online posting of 340B ceiling prices by a federal agency.

Rich Daly May 6, 2019

Hospitals See Improvement in Value Contracting with Commercial Plans

Hospitals continue to have more difficulty establishing value-based contracts with commercial health plans than with government payers, but that may be changing.

Rich Daly May 6, 2019

Medicare rates increasingly impacting health care

Even assuming the federal government does not adopt a single-payer model such as Medicare-for-all, industry watchers see Medicare’s impact on the healthcare sector expanding.

Rich Daly May 6, 2019

Provider payment standard draws congressional focus in surprise-bill debate

The fault line in congressional discussions this week on addressing surprise medical bills involved the best approach to determining provider payment in such situations.

Rich Daly May 6, 2019

What value-based payment changes are coming at the federal level?

Expect a post-acute care bundle, rural-focused alternative payments, value-based payment approaches inspired by Medicare Advantage (MA), and additional mandatory models from the federal government, a top official said this week.

Rich Daly May 6, 2019

Maryland’s global budget model: Impact on overall healthcare utilization remains murky

Implementation of global budgets at some Maryland hospitals cut utilization for several services, according to recent research, but evidence suggests the care merely shifted to other hospitals and providers.

Rich Daly May 6, 2019

March 18-22: What Events Are Coming in Health Care

Next week’s healthcare finance events and developments include HFMA’s Revenue Cycle Conference in Austin, Texas.

Rich Daly May 6, 2019

March 25-29: What Events Are Coming in Health Care

Next week’s healthcare finance events and developments include the deadline to submit comments on changes to the CMS hospital overall star ratings.

Rich Daly May 6, 2019
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