Preparing for Value-Based Payment: Fundamental Change That Encompasses the Revenue Cycle
The transition to value makes it necessary for healthcare organizations to find new ways to adapt to change.
Time for a Medicare Check-Up
A “Medicare check-up” can ensure a hospital is complying with regulations and maximizing revenue opportunities.
From Multiple Health Plans Back to “No Plan”
Healthcare reform may have been temporarily sidelined, but the need to reform, repair, or replace the Affordable Care Act remains.
Understanding CJR Payment Reconciliation
Deirdre Baggot looks at the Comprehensive Care for Joint Replacement program one year in.
Ask the Experts: Managing Health Plan Overpayments
I have heard there is a rule that health plans cannot recoup overpayments that are more than one year old. Does that stipulation vary by state, or is that a rule that is negotiable per contract?
Ask the Experts: Contracting with Small Health Plans
When negotiating with large and small health plans, what areas of comparison should I look at to be sure I am getting the same levels of service from the various plans?
HFMA Comments on CMS’s EPM IFR
HFMA submitted comments to CMS on EPMs; Cardiac Rehabilitation Incentive Payment Model; and Changes to the CJR; Delay of Effective Date interim final rule
Executive Summary: CMS 2018 IPPS Proposed Rule
This summary contains key financial and operational impacts from the FY18 IPPS proposed rule, published by CMS.
The Move to Office-Based Services Not Yet Showing Impact
Although commercial health plans have tried to equalize payments between hospital and office-based settings, hospital payments still remain higher and share of procedures by site have remained consistent.
Why Health Plans Are Easing Preauthorization
In an attempt to build cooperative working relationships with physicians, some health plans are trying to reduce the burden of preauthorization.