Case Example: A Large Medical Group Transitions to Value
The transition to value makes it necessary for healthcare organizations to find new ways to adapt to change.
Where’s the Risk
The secret to success under value based payments is an organization’s ability to identify and stratify risk. Risk falls into four basic categories Financial risk—managing with less revenue than in the pastQuality related risk—meeting requirements for qualityClinical risk—achieving agreed upon
How the AHCA’s Failure Could Rekindle the Lost Art of Compromise in Washington
With stalled efforts on both sides of the aisle, it may be time for Democrat and Republican leaders to come together on healthcare legislation.
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