Payment Reimbursement and Managed Care

Healthcare News of Note: Average billed charge for complex COVID-19 hospitalizations is more than three times the allowed amount

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: $317,810 is the average charge for a complex COVID-19 hospitalization, the pandemic has had a unique impact on people with disabilities, and transitional clinic care brings posthospitalization benefits for medically complex patients.

Deborah Filipek October 1, 2021

Focus on thought leadership and better practices: A testament to HFMA’s vision and purpose

From its very inception, HFMA has embraced the idea of thought leadership and professional practice. Major milestones have included the Principles and Practices Board, The Patient Friendly Billing Project, The Value Project and the recent focus on consumerism.

Eric C. Reese, PhD September 30, 2021

After a long wait, HHS sends out details on the next Provider Relief Fund distributions

The U.S. Department of Health and Human Services announced $25.5 billion in upcoming distributions from the Provider Relief Fund.

Nick Hut September 28, 2021

Site-of-care payment issues get highlighted by UnitedHealthcare and MedPAC

A new report issued by a leading health plan is the latest sign that hospitals and health systems can expect payers to ramp up implementation of site-neutral payments.

Nick Hut September 27, 2021

Cost Effectiveness of Health Report, September 2021

HFMA’s Cost Effectiveness of Health Report, sponsored by Kaufman Hall, is a monthly e-newsletter that will explore ways to ensure healthcare delivery in the United States is not only financially sustainable but also cost effective for all of its stakeholders — including health systems, physicians, health plans and patients. In this inaugural issue of the report, healthcare futurist Jeff Goldsmith shares his perspectives on the need for a focus on improving cost effectiveness of health as a societal imperative.

HFMA September 27, 2021

Why responding to site-neutral payment risk is imperative for hospitals and health systems

As the likelihood of site-neutral payments increases over a range of services, hospitals and health systems must understand which services are most at risk from these changes and determine how quickly they will respond.

Dawn Samaris, MBA September 27, 2021

Recipients of COVID-19 vaccine boosters won’t have to pay anything out of pocket, CMS confirms

Medicare beneficiaries will owe nothing out of pocket for receiving an authorized booster dose, and the same applies to almost all Medicaid beneficiaries and most commercial health plan members.

Nick Hut September 26, 2021

Healthcare price transparency initiatives may fall flat due to systemic factors, expert says

Niall Brennan, a leading expert on healthcare cost drivers, is among the skeptics who doubt the ongoing price transparency push can result in a more efficient system.

Nick Hut September 23, 2021

New rule describes the penalty associated with regulations on surprise billing

A new rule from HHS sets forth the maximum penalty for violations of new patient-billing regulations that take effect Jan. 1, 2022.

Nick Hut September 14, 2021

Payment, Reimbursement and Managed Care

Keep up with the latest payment, reimbursement, and managed care trends and related subtopics of accountable care, payment models, MACRA, Medicaid and Medicare reimbursement, value-based payment, reform, and more.

HFMA September 13, 2021
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