Payment Reimbursement and Managed Care

Jan. 20-24: MACPAC policy meeting among upcoming healthcare finance events

A complete listing of healthcare finance-related hearings, conferences, webinars, public forums and deadlines for the week of Jan. 20.

HFMA January 17, 2020

BESLER: Full-service Transfer DRG revenue recovery

BESLER talks about its Transfer DRG revenue recovery service that helps hospitals recover monies they have rightfully earned while maintaining compliance.

HFMA January 16, 2020

Limited BPCI savings seen with joint replacement bundles

CMS’s new BPCI-A model incorporates patient complexity into the risk-adjustment mechanism, but it remains to be seen if it will solve all issues with the previous model.

Chad Mulvany, FHFMA January 15, 2020

BPCI Advanced participation jumps by 57% in its third year

Provider participation in the largest Medicare voluntary bundled payment program surged in its third year.

Rich Daly January 15, 2020

Analysis: Aspire Health Founder Brad Smith chosen as new CMMI director

The change in CMMI leadership could mean long-anticipated models are released, and may signal more emphasis on palliative care in future models based on Brad Smith’s background.

Chad Mulvany, FHFMA January 14, 2020

Addressing the social determinants of health

Nancy Johnson, CEO of El Rio Community Health Center in Tucson, talks about her organization’s processes for addressing the social determinants of health among its patient population. The interview is a follow-up to a panel discussion at HFMA's 2019 Thought Leadership Retreat. Also in this episode: insights on effective leadership of teams and pricing strategy objectives.

Erika Grotto January 13, 2020

Atrius Health: Experience with global-risk contracts paves way to success in new arrangement

Previous success in risk-based contracts will allow Atrius Health to thrive in its new global-risk arrangement with Blue Cross Blue Shield of Massachusetts, two of the provider’s leaders write.

Patrick Holland January 13, 2020

Number of Medicare ACOs stays flat, but risk-taking increases

The number of Medicare ACOs has stagnated, but many more are taking on financial risk.

Rich Daly January 13, 2020

Cautionary tales: Why some payer-provider initiatives have stumbled

Health system leaders that are considering launching a provider-sponsored health plan can take a lesson from the experiences of organizations that faced challenges in pursuing such a strategy.

Richard Weil, PhD January 10, 2020

Many voters oppose giving government authority to set all healthcare prices

More voters oppose broad government rate-setting than support such an approach to addressing healthcare cost increases, according to a poll.

Rich Daly January 9, 2020
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