Payment Reimbursement and Managed Care

Fitch issues warning about looming start of hospital repayments to Medicare

Hospitals could struggle to repay Medicare loans, which will come due soon, amid re-impositions of elective surgery bans.

Rich Daly July 9, 2020

Hospitals scramble to meet price transparency requirements after court decision

Hospitals have a lot of costly work to do to meet CMS requirements to publicly post the rates they negotiate with health plans.

Rich Daly July 7, 2020

COVID-19 impact on independent primary care physician practices could accelerate the shift to value based payment

Health plans are taking this opportunity to align more closely with independent PCPs, including BCBS of North Carolina, where practices’ acceptance of financial support requires them to join one of health plan’s existing ACOs.

Chad Mulvany, FHFMA June 30, 2020

110,000 Medicare beneficiaries were hospitalized for COVID-19 by mid-May

By mid-May, hospitals had treated 110,000 Medicare beneficiaries for COVID-19.

Rich Daly June 26, 2020

Possible compromise in hospital price disclosure fight

While the Trump administration prevailed in the first round of the lawsuit challenging its price transparency policy, the American Hospital Association has indicated it will appeal the ruling.

Chad Mulvany, FHFMA June 25, 2020

Hospital margins positive in May due to temporary federal boost, report finds

Federal assistance temporarily boosted hospital margins in May into positive territory.

Rich Daly June 25, 2020

HHS’s Cares Act Provider Relief Act FAQ updates provide additional guidance for healthcare providers

HFMA's Chad Mulvany reviews four updates from the U.S. Department of Health & Human Services, including quarterly reporting requirements, that could be of interest to HFMA members.

Chad Mulvany, FHFMA June 23, 2020

Texas Oncology streamlines operations to achieve success in Medicare value-based payment model

The experience of Texas Oncology in CMS’s Oncology Care Model shows how provider organizations can use change management processes to lay the foundation for success in new care delivery models.

Elizabeth Barker June 22, 2020

Bundled payment participants face choices on 2020 performance measurement, continued participation

CMS further detailed how hospitals should evaluate their 2020 options and whether to continue in the BPCI-A model.

Rich Daly June 22, 2020

CMS aims to spur value-based payment arrangements between drugmakers and insurers, including Medicaid

CMS says rule changes would allow more outcomes-based payment arrangements for Medicaid programs and commercial health plans.

Rich Daly June 19, 2020
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