Payment Reimbursement and Managed Care

Bundled Payments for Care Improvement Advanced: 5 Critical Issues

When considering whether to participate in the Bundled Payments for Care Improvement Advanced program, hospitals and health systems should examine five key areas that could affect their performance under the program.

John M. Harris, MBA May 30, 2018

How Medicare ACOs May Respond to Spiking Risk

May 29—Accountable care organization (ACO) leaders are girding for changes to the Medicare ACO program that may require the vast majority in upside-only models to take on downside risk.

Rich Daly May 30, 2018

Areas of Healthcare Policy Agreement Would Target Hospitals

May 25—Emerging areas of bipartisan health policy agreement include hospital-targeted policies, according to policy experts.

Rich Daly May 29, 2018

Navigating Value-Based Reimbursement

A roundtable discussion about value-based reimbursement challenges, opportunities, and strategies for success.

HFMA May 24, 2018

Value-Based Care Is a Better Investment for Everyone

Griffin Myers explains the value of value-based care.

Griffin Myers May 24, 2018

Hospitals Worry Rule Could Lead to Medicaid Rate Cuts

May 23—Proposed changes to federal Medicaid rules could hit hospitals’ bottom lines, advocates warned.

Rich Daly May 24, 2018

CMMI’s “New Direction” Comments Indicate Enthusiasm of Healthcare Stakeholders

Dave Terry describes how feedback to a CMS announcement last fall has spurred another request.

Dave Terry May 22, 2018

How MA Plans Are Changing VBID Approaches

May 18—Medicare Advantage (MA) plans are evolving their approaches in the expanding Medicare pilot for value-based insurance design (VBID).

Rich Daly May 21, 2018

Methodology Used to Identify Top Procedures Performed at Hospitals and Free-Standing Clinics

Recent research on hospital versus free-standing facility pricing used 2016 Medicare hospital OPPS data as its basis.

HFMA May 18, 2018

A Look at Two Blues’ Distinct Approaches to Changing the Healthcare Model

May 16—Two dominant not-for-profit health plans—both Blue Cross insurers—are moving aggressively in very different directions.

Rich Daly May 17, 2018
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