Payment Reimbursement and Managed Care

Congress seeks stepped-up hospital price transparency enforcement as compliance issues continue to emerge

The bipartisan leadership of a congressional committee is urging HHS to enforce price transparency rules more stringently.

Nick Hut April 15, 2021

HFMA’s virtual Cost Effectiveness of Health Summit May 6-7 addresses the healthcare industry’s continuous spending growth and explores a more sustainable model

Healthcare leaders will begin collaborating on how to address the industry’s continuous spending growth and work toward a more sustainable future during HFMA's virtual Cost Effectiveness of Health Summit May 6-7.

Deborah Filipek April 14, 2021

Hospital investments should emphasize the virtual over the physical, Wall Street panelists say

Virtual-care capacity represents a better investment for healthcare providers than brick-and-mortar expansions, according to a Wall Street analyst.

Nick Hut April 12, 2021

CMMI announces Direct Contracting participants but cancels second round of applications

The Center for Medicare & Medicaid Innovation announced the 53 entities that have been accepted as participants in the new Global and Professional Direct Contracting model.

Nick Hut April 9, 2021

Healthcare News of Note: Federal bailout money helped some of the nation’s wealthier hospitals prosper despite COVID-19

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles, including wealthier hospitals prospering despite COVID-19, oncologists seeing more new advanced-stage cancer patients and the burden of prior authorizations during COVID.

Deborah Filipek April 9, 2021

Better integration with primary care can help address the ongoing mental health and addiction crisis, report finds

Enhanced network adequacy standards, value-based payment models and targeted investments in technology are vital to improving behavioral healthcare in a way that will meet escalating needs.

Nick Hut April 5, 2021

HHS should ensure 340B hospitals remain eligible despite changes in payer mix, AHA says

Hospitals participating in the 340B Drug Pricing Program could lose access due to payer mix changes stemming from the COVID-19 pandemic unless HHS issues a waiver.

Nick Hut April 1, 2021

Financial Analytics Leadership Council members share 5 challenges, responses to pandemic’s financial long haul

Financial leaders discuss how the pandemic has impacted revenue, volume and expenses, which has thus created a need for data and analytics.

HFMA March 31, 2021

Risk contracting: Outlook and success factors for hospitals and health systems

An December 2020 HFMA survey, sponsored by GHX, found high levels of optimism, overall regarding the future of value-based payment.

Eric C. Reese, PhD March 30, 2021

Implications of the HFMA-GHX study of risk-based contracting

In this article discussing implications of the findings of a December 2020 HFMA study, sponsored by GHX, healthcare leaders share their perspectives on key factors contributing to their organizations' success under value-based contracts.

Eric C. Reese, PhD March 30, 2021
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