Payment Reimbursement and Managed Care

Legislation on Surprise Billing Targets Insurers

Sept. 18—Following a recent survey that found the general public blames insurers for unexpected healthcare bills, high-profile draft legislation that would primarily target payers was offered this week.

Rich Daly September 19, 2018

Don’t Steer Away from Auto Accident Revenue Cycle Challenges

Brad Williams describes helpful strategies for recovering payments due based on patient involvement in auto accidents, which can be difficult to navigate but well worth pursuing.

Brad Williams September 18, 2018

CY 2019 OPPS/ASC Proposed Rule: HFMA Executive Summary|HFMA

CMS published a proposed rule updating OPPS/ASC payments for CY 2019, in the July 31, 2018, Federal Register.

HFMA September 17, 2018

Mandatory Bundle Gets Early Positive Results

Sept. 14—Hospitals in Medicare’s first mandatory bundled payment model succeeded in cutting Medicare gross spending in their first year, according to a new analysis. The results come as Trump administration executives say they plan to introduce more mandatory models.

Rich Daly September 17, 2018

Hospitals Express Opposition to E/M Code Changes

Sept. 12—A Medicare proposal to simplify evaluation and management (E/M) codes could hit hospitals’ bottom lines, hospital advocates recently warned the Trump administration.

Rich Daly September 13, 2018

Will New ACO Findings Save Upside-Only Models?

Sept. 11—A new analysis joins other research in reaching new conclusions about the extent of savings that accountable care organizations (ACOs)—especially upside-only models—provide Medicare. It’s a data battle that could determine whether many ACOs continue.

Rich Daly September 12, 2018

Health System Demonstrates Meaningful Price Transparency Is Possible

Baptist Memorial Health Care’s online Expense Navigator allows patients to estimate out-of-pocket expenses according to their insurance status and check their eligibility for financial assistance.

Lola Butcher September 11, 2018

PTAC Recommends New Models Amid HHS Promises

Sept. 10—Amid Medicare promises to soon introduce new physician-focused payment models, its leading advisory panel recently approved new models for consideration.

Rich Daly September 11, 2018

HFMA Comments on the CY 2019 Physician Fee Schedule Proposed Rule

HFMA submits comments to CMS on the CY 2019 Medicare Physician Fee Schedule Proposed Rule, published in the July 27, 2018, Federal Register.

HFMA September 10, 2018

Sept. 10-14: Unified Post-Acute Payment System Emerging

Sept. 6—As post-acute care leaders gather outside Washington, D.C., for a conference next week, a major payment overhaul is coming together.

Rich Daly September 7, 2018
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