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.
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.
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.
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.
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.
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.
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.
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Stay up-to-date with HFMA's regularly published news that covers regulatory and legislative changes and healthcare finance trends.
AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more
The new set features more than 400 CPT code changes from 2021.
COVID-19 vaccination of staff now a condition of participation in Medicare and Medicaid, CMS announces
In a major expansion of COVID-19 vaccine requirements, the Biden administration announced Sept. 9 that all staff working at Medicare- and Medicaid-certified facilities must receive the vaccine.