Payment Reimbursement and Managed Care

Decoding MSPB: Trending Better Faster

Dale Schumacher and Fern Nerhood describe how trends in Medicare spending per beneficiary can affect hospital finances.

Dale N. Schumacher May 16, 2018

340B Targeted in Trump Administration Drug Push

May 15—Hospital advocates and others raised concerns about impacts of the Trump administration’s recently announced initiative to address rapidly rising drug prices in part through policy changes to an existing drug discount program.

Rich Daly May 15, 2018

FY2019 Skilled Nursing Facility Proposed Rule Summary

This document summarizes the FY2019 proposed rule updating the skilled nursing facility (SNF) payment rates.

HFMA May 15, 2018

Former CMS Leaders: ACO Changes Are Coming

May 11—Medicare accountable care organizations (ACOs) are likely to face an imminent overhaul, according to former leaders of the program.

Rich Daly May 14, 2018

Competing with Freestanding Outpatient Centers—Where to Focus on Pricing

Price reductions should be included in pricing strategies to help hospitals better compete with these free-standing centers.

Scott Houk May 11, 2018

May 14-18: Senate Holds 340B Hearing Amid Surge in Activity

May 10—Congress will once again examine the 340B discount drug program next week amid several judicial and regulatory developments related to the program.

Rich Daly May 10, 2018

Avoid ED Claim Challenges by Developing CDI Teams

UnitedHealthcare’s new policy of auditing certain emergency department claims should prompt hospitals to seek the expertise of clinical documentation improvement teams in outpatient claim processing. 

Lola Butcher May 9, 2018

Ask the Experts: Calculating Contract DRGs

What is a simple way to accurately determine my current base DRG rate?

HFMA May 9, 2018

PHI Disclosure Management in the Business Office: Two Options for Greater Efficiency

Don Hardwick describes ways healthcare organizations can improve the process of releasing medical records to insurers.

Don Hardwick May 9, 2018

FY2019 Medicare Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule

This summary highlights key provisions of the FY2019 Medicare inpatient rehabilitation facility prospective payment system proposed rule, published by CMS.

HFMA May 8, 2018
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );