Payment Reimbursement and Managed Care

Latest COVID-19 federal assistance only partially targets hospitals

Hospitals will quality for only some of the new provider-assistance funding pools HHS unveiled this week.

HFMA June 10, 2020

Safety net hospitals could see increase in payments if CMS updates estimates of uninsured in 2021 IPPS final rule

HFMA's Chad Mulvany explains why a small percentage point increase in the uninsured rate could significantly impact the UC DSH dollars available to safety net hospitals at a time when they are financially struggling due to COVID-19.

Chad Mulvany, FHFMA June 8, 2020

Optum’s naviHealth acquisition will help lower the total cost of care for UHC members and Optum physician practice patients

Optum's naviHealth purchase rounds out is capabilities, ensuring its UHC members — particularly MA members and Optum's practices' patients — receive the right care in the right setting at the right time post hospitalization.

Chad Mulvany, FHFMA June 4, 2020

CMS acts to limit losses for participants in value-based payment programs during COVID-19

CMS offered numerous ways that providers in value-based payment models can reduce their financial risk during the COVID-19 pandemic.

Rich Daly June 4, 2020

With 26,000 COVID-19 deaths in nursing homes, CMS ties money to outcomes

New federal data show that although only 4% of COVID-19 infections occurred in nursing homes, 17% of deaths from the disease happened in those locations.

Rich Daly June 3, 2020

Study: Medicare Advantage enrollees less likely than traditional Medicare enrollees to use both institutional post-acute care and home health care

HFMA's Chad Mulvany says where there is competition for PAC discharges, providers should partner with high-quality PAC providers.

Chad Mulvany, FHFMA June 2, 2020

Building a healthcare finance center of excellence: a view from the C-suite

Finance centers of excellence are not necessarily physical locations but rather a collection of the right people, tools and practices to help organizations achieve better financial performance.

Frank Stevens June 1, 2020

As states anticipate Medicaid shortfalls, hospitals urge Congress to bolster commercial plan enrollment

Hospitals are emphasizing steps to boost commercial health plan enrollment over Medicaid enrollment.

Rich Daly May 29, 2020

State public option efforts waiver in face of the COVID-19 pandemic

HFMA's Chad Mulvany says although COVID-19 may have "dampened enthusiasm" for Washington state's public option, he is not sure the blame for its slow start rests solely, or even partly, on COVID-19.

Chad Mulvany, FHFMA May 28, 2020

Slow financial recovery expected for hospitals after COVID-19 pandemic

Industry leaders and advisers expect hospital revenue will not return to pre-pandemic levels this year — regardless of a second coronavirus wave.

Rich Daly May 28, 2020
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