Where Health Plan-Provider Value-Based Partnerships Trip Up
May 1—An inability to successfully integrate clinical and claims data is among the key challenges in creating and sustaining health plan-provider value-based partnerships, said an executive involved in one such effort.
Medicare Offers Post-Acute Care Pay Boost
April 30—Faced with operating headwinds, post-acute care providers stand to garner an unexpected FY19 payment boost from Medicare.
HFMA Overview: Affordable Care Act HHS Notice of Benefit and Payment Parameters for 2019 Summary of Final Rule
This presentation summarizes the Notice of Benefit and Payment Parameters for 2019 final rule, published by CMS, in the April 17, 2018, Federal Register.
HFMA Regulatory Overview: 2019 Medicare Advantage Final Rule
This presentation provides an overview of CMS's 2019 Medicare Advantage program final rule, published in the April 16, 2018, Federal Register.
Choosing the Right Path Forward for Value-Based Care
Thomas Schenk, MD, of BlueCross BlueShield of Western New York describes the health plan’s approach to supporting primary care physicians with a capitated payment system that accounts for local-market characteristics.
The Study of Factors Influencing the Total Cost of Health Care
A study conducted by HFMA, Leavitt Partners, and McManis Consulting investigated factors driving the total cost of health care in the United States.
What Is Driving Total Cost of Care?
A recent study identifies key factors that may be influencing total cost of care in the United States and provides recommendations for addressing those factors.
How Provider-Led ACOs Can Generate Long-Term Savings
Providers with concerns about the elusive success of ACOs should adopt some key strategies for implementation.
Creating APMs for Specialty Care: A Provider-Led Initiative for Delivering Value
The experiences of a large urology group practice can provide finance leaders with insight into key considerations involved with developing an advanced alternative payment model (APM) for a healthcare specialty area.
MA Ruling May Signal Industry Readiness to Integrate SDH into Traditional Medical Care
In addressing social determinants of health and social services, a recent Medicare Advantage ruling by CMS may have taken the first steps toward providing more integrated and comprehensive care to the nation’s aging population.