Reimbursement

Cleveland Clinic strikes deal to provide virtual second opinions to Aetna members

HFMA's Chad Mulvany says center of excellence models, similar to those the Cleveland Clinic partners with, select employers that have proven ability to reduce the total cost of care and improve outcomes.

Chad Mulvany, FHFMA August 26, 2020

Looking beyond CMS: How to accelerate the transition to value in healthcare

HFMA's Chad Mulvany summarizes a blog on actions CMS and Congress can take to transition providers to capitated and other risk-bearing payment models.

Chad Mulvany, FHFMA August 24, 2020

HHS updates COVID-19 payment and reporting requirements

Hospitals will need to meet testing requirements after Sept. 1 to receive future Medicare payment increases for treating COVID-19 patients.

Rich Daly August 21, 2020

U.S hospitals can no longer afford the burden of administrative waste

Even before the COVID-19 crisis, U.S. healthcare providers faced growing challenges from administrative and regulatory burdens. But the pandemic has these challenges to the point that they mare likely to impose severe financial consequences on providers.

Alan S. Kaplan, MD, MMM, FACPE August 20, 2020

Proposed CY 2021 Medicare Physician Fee Schedule changes: Analysis of impact on telehealth flexibilities and E/M coding

HFMA's Katie Gilfillan says the E/M coding changes taking place January 1, 2021, will have significant impacts not only to primary care physicians but also will have significant impact on specialist’s reimbursement.

Katie Gilfillan August 20, 2020

Employers pivot from value-based payment to virtual care amid the pandemic

Employer-sponsored health plans are pausing value-pay expansions in favor of adding virtual care options in response to the COVID-19 pandemic, according to a business group survey..

Rich Daly August 19, 2020

CARES Act Provider Relief Fund FAQs undergo another update as of August 14

HFMA's Chad Mulvany recommends healthcare leaders who think their organizations qualify for Phase 2 General Distributions review the FAQs.

Chad Mulvany, FHFMA August 17, 2020

Critical access hospitals will avoid Medicare cuts stemming from Paycheck Protection Program loans, Verma says

CMS does not intend for PPP loans to factor into Medicare payments to rural providers, the agency’s administrator recently clarified.

Rich Daly August 14, 2020

Rural payment pilots could pave the way to revamped hospital business models

A new rural payment model will test capitated and ACO payments and could encourage major changes in hospital business models.

Rich Daly August 12, 2020

Fewer cancer diagnoses in first weeks of the pandemic imply increased spending on cancer treatment in the future

HFMA's Chad Mulvany says good actuarial support is more important than ever for providers considering entering into risk-based models in response to the pandemic.

Chad Mulvany, FHFMA August 11, 2020
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