Payment Reimbursement and Managed Care

CY 2019 OPPS/ASC Final Rule: HFMA Executive Summary Presentation

This presentation briefly summarizes the CY 2019 OPPS/ASC final rule, published by CMS.

HFMA December 13, 2018

Medicare Enrollment Rate Will Peak in 2030

Medicare enrollment rate will increase by approximately 44 percent by 2030. After that time, the numbers will increase at much slower rates.

HFMA December 10, 2018

Hospitals Sue over $380 Million OPPS Cut

Dec. 5—Several hospitals and advocacy groups filed suit this week to stop a finalized Medicare payment change that would cut 2019 outpatient payments by an estimated $380 million.

Rich Daly December 6, 2018

The Blurring Boundaries of Elder Care: Implications for Providers and Patients

Healthcare providers are planning to invest in home health, palliative and end-of-life care, and geriatric caretakers in the coming years.

Jim Watson December 5, 2018

CY 2019 Medicare Physician Fee Schedule Final Rule

This document briefly summarizes the payment rate updates under the CY 2019 Medicare Physician Fee Schedule final rule, published by CMS.

HFMA December 4, 2018

Long-Delayed 340B Rule Takes Effect in January

Nov. 30—A highly anticipated rule to require better drug company compliance with a major discount drug program will go into effect Jan. 1—following multiple delays.

Rich Daly December 4, 2018

Your To-Do List When Health Plan Contracts Change

Six steps can help revenue cycle leaders manage health plan changes effectively.

Lola Butcher December 3, 2018

Surprise Medical Bills, Direct Primary Care Gain Senate Attention

Nov. 28—Senators said they will push legislation to limit surprise medical bills and to support direct primary care as part of congressional efforts to control rising healthcare costs.

Rich Daly November 29, 2018

CY 2019 OPPS/ASC Final Rule

This document highlights the payment rate updates for CY 2019, included in the hospital OPPS/ASC final rule, published by CMS.

HFMA November 27, 2018

Lessons from a BCBS Plan’s Plunge into Value-Based Payment

Nov. 26—Commercial insurers—and Blue Cross Blue Shield plans, in particular—have been shy about moving into value-based payment (VBP). But one southwestern insurer’s experience may help change that.

Rich Daly November 27, 2018
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