Payment Reimbursement and Managed Care

Health Plans, Providers Collaborate on Payment Transformation in Hawaii

More than 500 primary care providers have moved to per-member, per-month payments for patients covered by Hawaii’s largest health plan. The initiative may provide a roadmap for smaller physician practices to participate and flourish in the transition to value.

Lola Butcher June 20, 2018

Rejecting Hospital Concerns, Administration Expands Association Plans

June 19—Despite calls from major hospital groups to drop a proposed expansion of association health plans (AHPs), the Trump administration has finalized those rules.

Rich Daly June 20, 2018

Prospective Bundles, Downside Risk Models Trending: Survey

June 18—The prevalence of prospective bundled payment and downside risk among payment models offered by private health insurers surprised a sponsor of a new national survey.

Rich Daly June 19, 2018

Are MACRA Changes Coming?

June 13—The growing criticism of Medicare’s new physician payment system has produced calls for Congress to overhaul it. And some policy experts expect changes.

Rich Daly June 14, 2018

99 Percent of Physicians Who Seek APM Bonus Qualify for It

June 8—Ninety-nine percent of the 100,000 physicians who applied for the advanced alternative payment model bonus in the first available year qualified for it, according to a Medicare executive.

Rich Daly June 8, 2018

The Trump Administration’s Approach to Value

Ever since HHS Secretary Alex Azar announced that one of his priorities for the U.S. healthcare system would be to accelerate the shift to value-based care, industry stakeholders have awaited insight into how he would turn that priority into to policy action. 

Lia Winfield, PhD June 5, 2018

Will CPC Model’s Failings Follow into CPC+?

June 1—Improving the practice of medicine at the primary care level by deploying massive, publicly-funded incentives is complicated, but doable on the margins.

Joseph Conn June 1, 2018

Video: The Evolution of Payment Models

François de Brantes, former vice president and director for the Altarum Payment Institute, discusses payment models.

HFMA June 1, 2018

June 4-8: High-Deductible Health Plans Draw Congressional Scrutiny

May 31—Amid record-breaking enrollment in high-deductible health plans (HDHPs), a congressional panel plans to examine their growth and consider policies to bolster health savings accounts.

Rich Daly May 31, 2018

FY2019 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements

This document summarizes the FY2019 proposed rule updating the hospice wage index and payment rates.

HFMA May 31, 2018
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