Reimbursement

Key Senate committee takes a close look at healthcare waste and prices

The U.S. Senate is intent on finding ways to improve the value of healthcare, according to takeaways from a recent hearing of the Budget Committee. Although other committees and subcommittees in both chambers of Congress have held meaningful hearings about healthcare policy and costs this year, the Budget Committee’s attention to the matter is especially…

Nick Hut December 7, 2023

10 Keys to Restoring Trust in Healthcare

The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…

Nick Hut December 7, 2023

HFMA Comments on Federal Independent Dispute Resolution Operations, Proposed Rule

HFMA presents its comment letter on CMS’ Federal Independent Dispute Resolution Operations Proposed Rule.

HFMA December 6, 2023

CY 2024 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates

HFMA presents part III of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part III covers the updates to the Quality Payment Program.

HFMA December 4, 2023

The best of 2023 from HFMA’s editorial team

The HFMA editors share their favorite content from this year and provide a glimpse of what's to come in 2024.

Erika Grotto December 4, 2023

Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect

Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…

Nick Hut December 1, 2023

CY 2024 Physician Fee Schedule Final Rule Summary Part II – Medicare Shared Savings Program Requirements

HFMA presents part II of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part II covers the Medicare Shared Savings Program Requirements.

HFMA December 1, 2023

CY 2024 Physician Fee Schedule Final Rule Summary – Part I

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

HFMA December 1, 2023

Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut

Congress has mitigated a scheduled Medicare payment cut for physicians going into each of the last three years, but relief does not appear to be on the way for a fourth year running. Medicare’s 2024 final rule for physician payments includes a $1.15 decrease to the conversion factor, amounting to a reduction of more than…

Nick Hut November 27, 2023

Payer scorecards hold promise for promoting an enhanced payer-provider equilibrium

The U.S. healthcare system is fraught with inherent complexities in how providers receive payment for the services they deliver. And those complexities include conflicting methodologies that too often breed contentiousness between payers and providers around how, when and whether services will be reimbursed. Payer scorecards offer an effective solution for mitigating these tendencies. While they…

Eric C. Reese, PhD November 22, 2023
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