Payment Reimbursement and Managed Care

Should Physician-Led Models Get Value-Based Payment Privileges?

Joe Damore and Shawn Griffin describe the potential issues of granting special privileges to physician-led alternative payment models.

Joe Damore August 10, 2018

Aug. 13-17: Senate to Vote on HHS Funding

Aug. 10—The U.S. Department of Health and Human Services (HHS) would receive a small increase and funding for several hospital priorities under a FY19 funding bill that the Senate is expected to vote on next week.

Rich Daly August 10, 2018

6 Tactics of Successful ACOs

To gain the assurance of success under value-based care, all accountable care organizations (ACOs) should adopt the best practices of the most high-performing ACOs.

Rosemarie Day, MPP August 9, 2018

CMS Official: Logistical Limits Restricting New Payment Models

Aug. 8—Medicare has not approved more alternative payment models—despite calls by many hospitals and physicians for more of them—due to limits in time, staff, and funding, a Medicare executive said.

Rich Daly August 9, 2018

Are Employers Rethinking High-Deductible Plans?

Aug. 7—Employers that provide insurance for their workers are expressing an unusual degree of reluctance about high-deductible health plans (HDHPs).

Rich Daly August 8, 2018

IPPS Rule Includes Pay Bump, Reporting Simplification

Aug. 6—More than 3,000 hospitals will receive an average increase of nearly 3 percent in their Medicare inpatient payment rates—along with a slew of policy changes—under a recently issued final rule.

Rich Daly August 7, 2018

Aug. 6-10: As Navigator Deadline Approaches, Individual-Insurance Market Strengthens

Aug. 2—As the Trump administration prepares to accept the latest round of navigator applications this week, the individual health insurance market appears to be strengthening. 

Rich Daly August 3, 2018

Medicare Offers $1 Billion Increase, Policy Changes for Post-Acute Providers

Aug. 1—Post-acute care providers will see more than a $1 billion pay boost for FY19—along with a range of policy changes—as described in annual final rules issued by Medicare this week.

Rich Daly August 2, 2018

Medicare Proposes $760 Million 2019 Hospital Cut

July 27—A range of major hospital policy changes includes a $760 million cut as part of the 2019 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.

Rich Daly July 31, 2018

Number of MSSP ACOs and Shared-Savings Characteristics

The number of ACOs participating in the Medicare Shared Savings Program increased at a faster rate from 2013 to 2018 than did the number of participants that achieved shared savings in the first four years of the program.

HFMA July 27, 2018
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