Payment Reimbursement and Managed Care

Newer payment models should be part of holistic transformation efforts, CMS deputy administrator says

Healthcare industry stakeholders can expect a new approach to how federal payment models are formulated, as a newly released rule for Medicare coverage of kidney care illustrates.

Nick Hut July 9, 2021

A closer look at the new surprise billing regulations: The impact on balance billing

New regulations on surprise billing will affect hospital billing processes starting in 2022.

Nick Hut July 9, 2021

Government agencies issue the first set of regulations restricting surprise billing

In a development that many healthcare stakeholders have awaited for months, four federal agencies on Thursday, July 1 released new regulations prohibiting surprise billing in many scenarios.

Nick Hut July 2, 2021

Healthcare News of Note: S&P says outlook is stable for not-for-profit healthcare sector

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: The not-for-profit healthcare sector outlook was upgraded to stable, new research explores the higher risks facing certain racial and ethnic groups during COVID-19, and OIG finds that CMS lacks the tools to assess hospital quality and safety during an infectious disease outbreak.

Deborah Filipek June 30, 2021

Healthcare leaders offer direction on key CMS inpatient proposals for FY 2022

HFMA offers direction to CMS on several of its key inpatient proposals for 2021 as many healthcare leaders have expressed concern about these proposals.

Shawn Stack June 30, 2021

Hospital groups raise red flags about spending offsets in bipartisan infrastructure bill

The bill would be paid for in part by extending the duration of the 2% reduction in Medicare payments and by tapping into the Provider Relief Fund.

Nick Hut June 29, 2021

Medicare should update its policies for separately payable drugs in the Outpatient Prospective Payment System, MedPAC says

Worthwhile changes include requiring drugs to be proven clinically superior before granting them pass-through payment status, according to a new report.

Nick Hut June 27, 2021

Financial Sustainability Report: June 2021

This June issue of the Financial Sustainability Report, sponsored by Kaufman Hall, leads off with results of HFMA’s recent report examining the evolving role of the healthcare CFO over the next decade. Two features also examine steps health systems can take to promote success with value-based payment initiatives, including developing models to inform their efforts with risk-based contracts and focusing efforts on removing impediments to success under such contracts.

HFMA June 25, 2021

Healthcare CFOs should ensure their organizations’ contracts are well administered to avoid financial risk exposure

Administering contracts is a core activity for healthcare organizations, given that contracts collectively reflect the organization’s business obligations, including all assets, relationships and terms it is required to manage. It therefore is an important concern for the senior finance leader.

Nathan Hershkowitz June 25, 2021

Healthcare News of Note: Struggling rural hospitals have option to become stand-alone EDs to receive more funding

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: An upcoming option for rural hospitals to receive more funding, a key factor in outcomes of Black patients who receive COVID-19 care, and predictions about the hospital room of the future.

Deborah Filipek June 25, 2021
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