Payment Reimbursement and Managed Care

MedPAC Recommends $250 Million ED Cut

April 9—Medicare should cut payment rates for many emergency departments (EDs) by 30 percent, Congress’s leading Medicare advisory panel recommended this week.

Rich Daly April 9, 2018

Ask the Experts: Medicare Small Balance Payments

Is there any concern if copayment under a certain amount are written off?

HFMA April 6, 2018

Contracting for Primary Care and Value Improves Patient Outcomes and Lowers Costs

Humana offers primary care practices four types of value-based contracts, but also customizes plans that emphasize population health or other initiatives.

Lola Butcher April 6, 2018

FFS Medicaid Most Challenging for Billing: Study

April 4—One of the first direct comparisons of billing complexities between various types of payers found that Medicaid fee-for-service (FFS) programs were the most challenging for providers.

Rich Daly April 5, 2018

Medicare Advantage Rates, Policies Draw Insurer Praise

April 3—Medicare Advantage (MA) plans received an unexpected pay boost and generally beneficial policies in the final call letter and rules issued this week for 2019.

Rich Daly April 4, 2018

Building a Resilient Managed Medicaid Program in the Face of Uncertainty

By collaborating with state agencies, a provider-sponsored health plan has thrived and expanded in an economically disadvantaged area.

Mark B. Carter April 3, 2018

LTCH Pay Change to Cover Less than Half of Costs: Analysis

April 2—An ongoing Medicare payment change will cover less than half of the costs of care for long-term care hospital (LTCH) patients who are subject to it, according to a new analysis.

Rich Daly April 2, 2018

Understanding Value

HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, talks about the need to develop a shared understanding of value.

HFMA April 2, 2018

Proposal to Eliminate MIPS Appears to Lack Provider Buy-in

March 26—The Medicare Payment Advisory Commission (MedPAC) earlier this month announced a proposal to drop the Merit-based Incentive Payment System (MIPS) program as part of its annual report to Congress on needed changes to Medicare payment policies. 

Rod Moore March 27, 2018

Federal Spending Bill Lacks Sought-After ACA Stabilization Measures

March 22—A bill to fund the federal government through the rest of FY18 includes various healthcare measures but does not incorporate a proposed stabilization plan for the Affordable Care Act’s (ACA’s) insurance markets.

HFMA News March 22, 2018
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );