Reimbursement

How to Get Involved in CAQH CORE’s Work

CAQH CORE currently is forming groups to work on healthcare data standardization. Healthcare finance professionals are a core constituent and CAQH welcomes their participation.

HFMA August 15, 2018

ACO Advocates Warn on Program Overhaul

Aug. 13—A proposed overhaul of Medicare’s primary accountable care organization (ACO) program could cause massive departures, advocates for the entities warned soon after it was issued.

Rich Daly August 14, 2018

Why Fee-For-Service Remains Prominent

Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.

HFMA August 14, 2018

Bundled Payment Deals Prompt Hospitals to Rethink Relationships with SNFs

Aug. 14—Hospital and health system CFOs who are trying to make bundled payments work may find an answer in closer clinical alignment with skilled nursing facilities (SNFs), according to a new study.

David Burda August 14, 2018

How to Really Know Your Payment Rates

A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.

Debra Ryan August 13, 2018

Hospitals Are Using Cost Reduction to Trim Patient Charges

The healthcare industry has undergone a major decrease in average annual charge growth. Hospitals at the lowest end of the charge growth spectrum are using cost reduction to slow the level of charge change. 

Jamie Cleverley August 13, 2018

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
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