Payment Reimbursement and Managed Care

Hospitals to lose Medicare, Medicaid access in 14 weeks if they don’t meet daily reporting requirements

Hospitals will have 14 weeks to meet daily data-reporting requirements related to COVID-19 and the flu or face termination from Medicare and Medicaid.

Rich Daly October 7, 2020

Cigna’s 2021 strategies highlight MA trends and the resulting effects on providers

One MA health plan discusses how it’s changing its Medicare Advantage plans in response to market trends, the pandemic, social determinants of health and Medicare policies.

Rich Daly October 2, 2020

Congress alters the terms for Medicare loans

Recently passed legislation relaxes terms of the Medicare Advanced and Accelerated Payment Program loans for hospitals and and other providers.

Chad Mulvany, FHFMA October 1, 2020

Innovating for Minimally Invasive Care

While looking ahead to a post-COVID world, a global technology company focused on minimally invasive care developed a surgical system equipped with data analytics capabilities that can provide organizations with insights to refine robotic-assisted surgery programs.

HFMA October 1, 2020

In a ‘setback,’ hospital margins, volumes decreased

Hospitals' financial recovery took a step backward in August, according to a monthly report.

Rich Daly September 29, 2020

Healthcare organizations should expect a surge in managed care audits and reviews in the COVID-19 aftermath

Healthcare providers should prepare for emerging trends in payer audits, reviews and associated information requests, after the brief lull in such activities that occurred with the onset of the COVID-19 pandemic.

Greg Ford September 28, 2020

How to lay the foundations for success under CMS’s new MDC program

The CMS Medicare Direct Contracting (MDC) program offers hospitals and health systems a unique opportunity take the next step in value-based payment and population health management. Success requires the right targeted investments in expertise and infrastructure.

Allen Miller, MPH September 28, 2020

3 contracting strategies to accelerate a COVID-19 financial recovery for providers

Having suffered significant losses due to the COVID-19 pandemic, healthcare providers require effective strategies to achieve a more equitable balance with payers, which have actually enjoyed a financial windfall as a result the pandemic.

Kathy Najarian, MHA September 28, 2020

Rand releases updated study of hospital payment variation in commercial market

HFMA's Chad Mulvany says it’s imperative that everyone in the U.S. supports safety-net hospitals, or there will be an increase in the disparities in access to basic healthcare services between the haves and have-nots.

Chad Mulvany, FHFMA September 25, 2020

Increased ACA uncertainty at the U.S. Supreme Court upon death of RBG

HFMA's Chad Mulvany says given the Supreme Court’s historically narrow view on severability, many legal experts doubt the court, even with its new makeup, will overturn the entirety of the ACA.

Chad Mulvany, FHFMA September 24, 2020
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