No-Pay Policy for Non-Emergent ED Use Spreading
A growing number of health plans are not paying for non-emergency patient use of the ED.
Bad Debt, Charity Care Contribute To Differences in Patient Revenue
Low margin hospitals may be receiving reduced payments from commercial insurance, which may contribute to their lower net patient revenues.
10 Critical Medicaid Trends to Watch
It is important for hospitals and health systems to forecast the impact of proposed healthcare legislation on Medicaid payments, eligibility teams, and patients.
Part B Drugs Revisited—Yet Again
Payment and pricing for Medicare Part B drugs are subjects of much discussion again following the decision by CMS to withdraw its planned pilot projects for these drugs.
How Providers Should Prepare for New Bundled Payments
Optimal preparation for new mandatory bundled payment models begins with establishing clear and achievable goals, focusing on inpatient costs and care variation, and reorganizing to manage post-acute spending.
Preparing for MACRA Success
Christopher Stanley provides pointers for healthcare organizations preparing for the merit-based incentive program.
HFMA Comments on CMS’s FY18 IPPS Proposed Rule
HFMA submitted comments to the CMS on the FY18 IPPS proposed rule published in the April 28, 2017, Federal Register.
Value-Based Care: Past, Present, and Future
Nick Vennaro delivers a retrospective on value-based care with an eye toward the future.
Ensuring Proper Payments for Substance Abuse Services
Substance abuse treatment providers can maximize payments through contract negotiations and eligibility verification and precertification processes.
Linking Professional Fee and Facility Fee Data to Get the Big Picture
Matching patient and encounter data helped one Vermont hospital overcome the challenges of working with two different billing systems for its facility and physicians.