Reimbursement

Sept 30-Oct. 5: ACA Premiums to Decline for First Time

Sept. 27—Final premium rates for the Affordable Care Act (ACA) marketplaces are expected to keep rolling in next week, even as the Trump administration is anticipating a historic first.

Rich Daly September 28, 2018

Rural Hospitals Push Congress to Address Key Financial Issue

Sept. 26—Amid rising concern in Congress over rural hospital failures, some stakeholders are renewing their push for a long-sought Medicare payment change that was described during a recent hearing as “one of the single most important” financial fixes for those organizations.

Rich Daly September 27, 2018

Bundled Episode “No-Go” Zone

Providers that are considering participating in bundled payment arrangements should first perform a preliminary review of factors that can have a bearing on their readiness for such arrangements.

Deirdre M. Baggot September 27, 2018

The Trump Administration’s Proposed Reorganization of the Federal Government: Implications for Health Care

President Trump is proposing significant reforms to government structure that may improve administrative efficiency but may at the same time gut what is left of the nation’s safety net.

Ken Perez September 26, 2018

Target Setting: A Case Example with Risk Adjustment

By considering risk as they set financial targets for physician groups under value-based payment contracts, provider organizations can more accurately assess the likelihood that physician groups might have favorable performance under the contracts.

HFMA September 26, 2018

The ongoing pursuit of better payment models

HFMA will be your source for all things related to payment trends, as it may be one of the hottest topics in our industry. 

Kevin Brennan, FHFMA, CPA September 26, 2018

Lessons Learned from New York State’s Transition to Value

New York is a leader among U.S. states in promoting the healthcare industry’s transition to value-based payment, and healthcare providers nationwide can benefit from understanding the details of the state’s approach. 

Michael Keyes, MBA September 26, 2018

7 Considerations in the Financial Modeling of Value-Based Payment Arrangements

In preparing for the impact of changing to value-based payment, hospitals must be able to predict the gain or loss from related incentives, penalties, volume changes, and other factors. Seven considerations provide a guide to successfully managing the shift. 

Jim Ryan September 26, 2018

Getting Proactive About Bundles

Building on lessons learned from early bundle experiences, a midwestern health system is proactively designing its own bundles as it works with insurers and the state to craft bundles that better represent clinical and operational realities.

Anne Stockton September 26, 2018

A Blueprint for Building a ‘Risk Ready’ Healthcare Organization

The cornerstone capabilities healthcare providers require for success under risk contracts are contract modeling and negotiation, care management and coordination, analytics and technology, and relationships and alignment.

Daniel J. Marino September 26, 2018
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