Payment Reimbursement and Managed Care

For-profit hospital outlook improves to stable, according to Moody’s

Moody’s shifted its outlook for for-profit hospitals from negative to neutral in response to ongoing federal assistance and an expected volume recovery.

Rich Daly December 2, 2020

Stark, Anti-Kickback changes draw praise from providers

Final rules modifying enforcement of the Stark Law and the Anti-Kickback Statute aim to remove barriers to participation in value-based payment models.

Rich Daly December 1, 2020

Telehealth: Moving from stop-gap measures to an integrated care delivery model

With telemedicine on the rise, two senior leaders advise having proper denials prevention and response strategy, along with ideas on motivating physicians to participate in telehealth programs.

HFMA November 30, 2020

News briefs: December-January 2020-21: Recent trends shaping healthcare finance

Read about the key factors that have shaped healthcare finance policy and practice.

Rich Daly November 27, 2020

Lessons learned from the transition from volume to value

To effectively transition to value, ACO must fully grasp the success factors that will determine future success under value-based payment, including success with downside risk. A research study examined key organizational, financial, market and other characteristics that support the decision to take on risk.

Bonnie B. Blanchfield, CPA, ScD November 25, 2020

Hospitals and health systems remain optimistic, overall, about APMs

An August HFMA survey, sponsored by GHX, found that, overall, hospitals and health systems are optimistic about seeing improvements in coordination and collaboration with partners in risk-based payment models over the next five years. The findings suggest organizations are moving ahead unabated in their value-based payment strategies.

Eric C. Reese, PhD November 24, 2020

HHS Provider Relief Fund clarifications provide much-needed information

Several clarifications related to the treatment of depreciation, expenses for stockpiling PPE and revenue to the HHS Provider Relief Fund (PRF) FAQs were released Nov. 18 by the U.S. Department of Health & Human Services.

Chad Mulvany, FHFMA November 24, 2020

CMMI releases interim final rule detailing the payment model for separately payable Part B drugs

HFMA's Chad Mulvany says it is likely drug manufacturers will sue to stop the rule, and they may have several strong legal arguments that would at least delay, if not overturn the rule.

Chad Mulvany, FHFMA November 24, 2020

Financial Sustainability Report: October 2020

The October 2020 Financial Sustainability Report, sponsored by Kaufman Hall, explores aspects of healthcare’s transition to value-based payment, including how to pursue a value-based approach to maternity care, and how the transitional approaches differ among hospitals and health systems based on each organization’s unique circumstances.

HFMA November 23, 2020

Financial Sustainability Report: September 2020

The September 2020 Financial Sustainability Report, sponsored by Kaufman Hall, explores looming imperatives and opportunities for healthcare providers, including the Medicare Direct Contracting APM and the price transparency rule, with guidance on steps to prepare.

HFMA November 23, 2020
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