Payment Reimbursement and Managed Care

Advancing Contracting Strategy in a Complex Environment

Providers should approach their contracting portfolios with the intent to drive value creation across all payers and products. Likely challenges will be narrow networks and tiering and the transition from fee-for-service to value-based care.

Steve Prosser January 17, 2018

Medicare ACOs Increase by 18 Percent in 2018

Jan. 16—Medicare increased its number of accountable care organizations (ACOs) by 18 percent in 2018, even as a participation cliff looms for many.

Rich Daly January 17, 2018

Why Hospitals Support Kentucky’s Medicaid Waiver

Jan. 15—Kentucky’s recently approved Medicaid waiver has drawn criticism for implementing “work requirements,” but hospitals say the details make it more palatable.

Rich Daly January 16, 2018

HHS Nominee Would Support Mandatory Models

Jan. 11—Mandatory Medicare payment pilots could return under the leadership of the nominee to direct the U.S. Department of Health and Human Services, he said this week.

Rich Daly January 12, 2018

Advisers See Good and Bad in New Voluntary Bundle

Jan. 10—Hospital participation in a new voluntary bundled payment program is expected to exceed that of any previous models, but the new program may not be right for every organization.

Rich Daly January 11, 2018

Medicaid Expansion Lessened Hospital Closures: Study

Jan. 9—The expansion of Medicaid eligibility under the Affordable Care Act (ACA) helped prevent some hospital closures in those states, according to new research.

Rich Daly January 10, 2018

Video: Participating in Bundled Payment Initiatives

Tamira Harris, PhD, MBA, MSN, business adviser for Change Healthcare, takes a look at how healthcare entities can get started with bundled payment initiatives, including care design and delivery.

HFMA January 9, 2018

When Push Becomes Pull: The Next Phase of the Transition to Value

The healthcare industry’s transition to value-based payment will likely continue, driven by physician interest in advanced alternative payment models.

Chad Mulvany January 9, 2018

High Discount Health Plans: Right for the Consumer, but What About PFS?

Organizations writing off more and more patient debt may want to explore new avenues for collaboration.

Jeff Helton,  PHD, FHFMA, CMA, CFE January 9, 2018

Proposed MA Change Positive for Plans: Analysts

Jan. 3—Proposed policy changes that were recently released for Medicare Advantage (MA) plans—coupled with expected rate increases—should boost those insurers, industry analysts say.

Rich Daly January 4, 2018
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