Payment Reimbursement and Managed Care

Success Factors for Getting High-Cost Drugs Approved

The University of Rochester Medical Center’s high-cost drug manager works to help patients get access to appropriate drugs and mitigates the financial risk associated with buying and administering them.

Lola Butcher October 9, 2018

Ask the Experts: Lesser-Than Provisions

What specific pitfalls should we look for in terms of lesser-than provisions?

HFMA October 9, 2018

The Conscience of the Generic Drug Market

Created to address the high costs and shortages of generic medications, the not-for-profit generic drug manufacturer Civica Rx aims to be a societal asset by providing patients across the nation with affordable access to the medications they need.

Jenna Jackson October 8, 2018

Oct. 8-12: ACO Changes Urged for Consideration by Administration, Congress

Oct. 3—Healthcare industry leaders will gather next week at various meetings that will include discussions of high-profile accountable care organization (ACO) programs. The Medicare ACO program particularly needs changes, providers told federal officials this week.

Rich Daly October 5, 2018

Keeping Up-To-Date on Shifting Medicaid Eligibility Laws

A government affairs expert shares strategies for keeping up with complex Medicaid rules and stay in compliance.

Marie Hinds October 4, 2018

Medicare Shared Savings Program “Pathways to Success” Proposed Rule

This document summarizes the Medicare Shared Savings Program - Pathways to Success proposed rule, published in the August 17, 2018, Federal Register.

HFMA October 3, 2018

Medicare Quality Pay Leads Practice Regulatory Burden

Oct. 2—Although insurance prior authorization and electronic health record (EHR) interoperability have garnered extensive attention as challenges for medical practices, a new survey fingers Medicare quality payment programs as the biggest hindrance.

Rich Daly October 3, 2018

Time to Reassess: Keeping Up with Changes to CJR Target Pricing

Performance improvement targets have shifted again in the Comprehensive Care for Joint Replacement (CJR) program. Darcie Hurteau explains why participants should reassess their program strategies in light of this change.  

Darcie Hurteau October 2, 2018

HFMA Comments on the CY 2019 OPPS/ASC Propsed Rule

HFMA submits comments to CMS on the CY 2019 hospital OPPS/ASC proposed rule, published in the July 31, 2018, Federal Register. 

HFMA October 1, 2018

hfm Magazine: October 2018

The October 2018 edition of hfm explores people and culture in healthcare finance, focusing on performance improvement, academic-community relationships, and care delivery.

HFMA October 1, 2018
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );