Not-for-Profit Hospitals Hit All-Time-Low Operating Margins: Moody’s
Aug. 29—Operating margins for not-for-profit hospitals fell to 1.6 percent in FY17, the lowest level one rating agency has ever found in its tracking.
5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission
Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.
Administration Meets Challenge to Risk-Adjustment Payments, Counter to Critics’ Assumptions
Responding to a New Mexico district court’s ruling against the risk-adjustment program established by the Affordable Care Act, CMS initially put the program’s payments to collections and payment on hold, but then took steps to reinstate the program.
4 Steps for Success in a Changing Payment Landscape
The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.
Next Gen ACO Savings Could Bolster Medicare ACO Changes
Aug. 27—The most advanced Medicare accountable care organizations (ACOs) saved $100 million in their first year, according to a new report. And such savings could bolster Medicare’s proposed transition to greater risk for other ACOs, some industry watchers said.
Ask the Experts: Bundled Payment Start Date and Allocation
What parameters have other hospitals used to set a start date for moving to a bundled payment versus fee-for-service?
Aug. 27-31: Individual Market Rates Roll in Amid Tweaks
Aug. 23—States are scrambling to implement last-minute supports for the individual-insurance markets, even as 2019 rates begin to be finalized.
Even Successful Medicare ACOs Lose Money: Analysis
Aug. 22—Accountable care organizations (ACOs) that succeeded in earning bonuses from Medicare garnered less revenue than they would have under the fee-for-service (FFS) payment system, a recent analysis found.
Understanding Pricing Trends in a Changing Environment
Pricing data can help providers make more informed strategic decisions and build better relationships with their patients.
A Push to Streamline Value-Based Payment
Value-based payment is ripe to repeat past fee-for-service problems—widespread slowdowns as each entity took different approaches to data collection and sharing and, as a result, hampering interactions. CAQH CORE is getting in front of these challenges now.