Payment Reimbursement and Managed Care

How CHRISTUS Health Supports Exchange Enrollment

CHRISTUS Health appoints regional executives who work with coalition partners to reach market-specific health insurance exchange enrollment goals.

Lola Butcher February 9, 2016

Executive Summary – Proposed MSSP “Benchmarking” Rule

The Centers for Medicare & Medicaid Services (CMS) released proposed changes to the Medicare Shared Savings Program (MSSP) benchmark rebasing methodology. The rule also includes several other significant changes that impact risk.

HFMA February 8, 2016

HFMA Comments on Medicare Program IPPS 0.2 Percent Reduction

HFMA comments on the assumptions CMS used to justify cutting payments to hospitals under the IPPS by .2% as outlined in Medicare Program: Inpatient Prospective Payment Systems; 0.2 Percent Reduction.

HFMA February 2, 2016

Comprehensive Care for Joint Replacement Payment Model Final Rule Fact Sheet

This document summarizes the Comprehensive Care for Joint Replacement (CCJR) model final rule released by CMS in the November 24, 2015, Federal Register.

HFMA January 19, 2016

Summary of CMMI Accountable Health Communities Model

This document provides information on the Center for Medicare & Medicaid Innovation's (CMMI's) three-track Accountable Health Communities Model designed to test whether or not integrating social supports into the delivery system will have a positive impact on health outcomes and expenditures. 

HFMA January 13, 2016

Negotiating Tips for ACO Contracting

Successful payer negotiations to launch commercial ACOs will depend on careful preparation and understanding of hospitals’ capabilities, says George Wojtal.

Karen Wagner January 12, 2016

Ask the Experts: Non-Contracted Insurer Payment Rates

How can providers respond when non-contracted insurers offer payments limited to some share of Medicare payments for a given service?

HFMA January 12, 2016

HFMA Comments on the CMS Discharge Planning Proposed Rule

HFMA comments on the CMS proposed rule on Medicare and Medicaid Programs: Revisions to Requirements for Discharge Planning for Hospitals, Critical Access Hospitals, and Home Health Agencies.

HFMA January 7, 2016

CY16 OPPS Final Rule Fact Sheet

This fact sheet highlights 2016 payment rate updates to outpatient hospitals and ambulatory surgical centers under the Medicare Outpatient Prospective Payment System (OPPS).

HFMA December 28, 2015

HFMA Comprehensive Care for Joint Replacement Final Rule Executive Summary

This Executive Summary provides the top 10 issues providers need to understand from the Comprehensive Care for Joint Replacement (CJR) final rule, published in the November 24, 2015, Federal Register.

HFMA December 22, 2015
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