Payment Reimbursement and Managed Care

Research highlights ways to save more than $250 billion per year through healthcare administrative simplification

Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.

Nick Hut October 22, 2021

Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say

A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.

Nick Hut October 21, 2021

Hospital groups express concern over earlier court ruling that could expand False Claims Act liability

The groups argue that allowing FCA claims to be brought for post-termination actions would defy congressional intent and leave hospitals subject to excessive financial liability.

Nick Hut October 19, 2021

Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.

Deborah Filipek October 19, 2021

With substantial Medicare payment cuts pending, medical groups call for Congress to act

Payment cuts scheduled for 2022 would amount to a 9.75% reduction in Medicare revenue for medical groups, which are calling on Congress to pass legislation to stop the cuts.

Nick Hut October 14, 2021

Healthcare M&A activity for Q3 remains low in volume but high in impact, firms report

The number of M&A transactions involving hospitals and health systems remained at historically low levels, but the average revenue involved was far higher than in recent years.

Nick Hut October 11, 2021

The finalized arbitration process in new surprise-billing regulations appears to favor insurers over hospitals

A new rule establishes a process for resolving payment disputes between health plans and hospitals when regulations on surprise billing begin in 2022.

Nick Hut October 8, 2021

Healthcare News of Note: U.S. will be short 3.2 million lower-wage healthcare workers within 5 years, says Mercer

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Shortages of lower-wage healthcare workers, nurses, physicians and mental health staff are expected, PHI security and burnout are of concern to most healthcare professionals, and the pandemic is expected to affect health insurance rates.

Deborah Filipek October 8, 2021

Consumerism and the transition to value are among the trends drawing strategic reactions from healthcare providers, survey finds

A recent survey finds healthcare providers working to ensure their strategic planning incorporates key trends, spurring innovations in care delivery models.

Nick Hut October 8, 2021

The stakes are only growing in efforts to improve the cost effectiveness of health, CMMI’s Elizabeth Fowler says

The head of the Center for Medicare & Medicaid Innovation spoke with an HFMA audience about the importance of efforts at the federal level and beyond to improve the cost effectiveness of health.

Nick Hut October 6, 2021
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );