Ripple effects of the pandemic on the move toward value
In this HFMA executive roundtable, seven executives for health systems and health plans share how the pandemic has impacted their organization’s move toward value — and what it will take to foster transparency and trust under these models.
The payer episode: CMS interoperability rules and provider strategies for better conversations
Chris Hobson, from Orion Health discusses CMS’s upcoming deadline for interoperability requirements for payers and Geneva Schlabach from Vispa and Mike Duke from Baker Tilly talk about denials management.
Employers again are planning to expand their use of narrow networks, survey finds
Large employers again say they plan a big increase in the use of narrow networks, a scenario made more likely by the pandemic.
Why effective maternity care requires an innovative, value-based strategy
An episode-of-care approach may be the best way to address cost variation in maternal care and promote partnerships across the healthcare continuum.
Providers should prepare for a possible expansion of Medicare site-neutral policies
HFMA’s Chad Mulvany says if the CY2021 OPPS rule is finalized as proposed without significant modifications to CMS's MS-DRG weight-setting process, it heightens the need for hospitals to expand outpatient/ASC capacity and continue aggressive cost management.
Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions
HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.
Medicare readmissions reduction program penalizes hospitals inaccurately, study finds
The hospital readmissions reduction program incorrectly penalizes hundreds of hospitals, according to new research.
Latest HHS provider relief fund FAQs offer insight into what’s permissible under the Sept. 19 reporting requirements
HFMA's Chad Mulvany says due to HHS's whipsaw approach to the provider relief fund FAQs and guidance, any clarity to be derived from the Phase 3 application instructions and FAQs needs to be considered with a measure of caution.
Changes coming to bundled payments and Direct Contracting, CMMI chief says
Coming changes will affect both Medicare bundled payment programs and the looming Direct Contracting program, said the director of the Center for Medicare and Medicaid Innovation.
More Medicaid programs are planning inpatient hospital payment cuts
States are moving to cut their Medicaid inpatient hospital rates amid the pandemic and its more than 400,000 hospitalizations.