Can Maryland Hospital Price-Setting Serve as a National Model?
April 10—Hospitals may have reasons to support a shift to a global budget model like the one used in Maryland, some healthcare policy leaders say.
Medicaid Waivers: Work Requirements Are Not the Only Changes Coming
Work requirements present unknown changes and impacts, but the impact may not be as big as some assume. However, what providers and recipients need to consider are the other and seemingly less significant changes that will intensify the overall impact of an 1115 Medicaid demonstration waiver.
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.
Ask the Experts: Medicare Small Balance Payments
Is there any concern if copayment under a certain amount are written off?
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.
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.
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.
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.
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.
Understanding Value
HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, talks about the need to develop a shared understanding of value.