Payment Models

What’s the blueprint for taking on risk?

Providers and health plans need to collaborate — both in the planning and execution of risk-based contracts — in order to make them work.

Rich Daly June 23, 2019

Medicare Advantage plans accelerating their move into SDOH, advocate says

Medicare health plans have increasing authority to grapple with the social determinants of health, and more are pursuing such initiatives.

Rich Daly June 12, 2019

Analysis: CMMI primary care initiatives: Potential opportunity but lots of questions

The five new alternative payment models offer multiple participation options for primary care practices of different sizes with advanced capabilities.

Chad Mulvany, FHFMA May 19, 2019

Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs

CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.

Chad Mulvany, FHFMA May 15, 2019

‘Medicare for All’: Do the numbers

Healthcare leaders can foster a productive debate about “Medicare for All” by driving analyses based on data such as cost projections, writes HFMA President and CEO Joseph J. Fifer.

Joseph J. Fifer, FHFMA, CPA May 15, 2019

Analysis: Another year closer to depleting the Part A Trust Fund

With the predicted depletion of Medicare’s hospital insurance fund, and Congress unlikely to increase taxes for working people or hike costs for beneficiates, what should healthcare finance leaders expect?

Chad Mulvany, FHFMA May 14, 2019

HFMA’s Payment Reform Project White Papers

HFMA has led a payment reform thought leadership initiative to identify the principles that should guide changes to the current healthcare payment system and the competencies that providers will need to succeed. The initiative's findings and recommendations are summarized in these white papers. 

HFMA February 28, 2019

Medicare’s Move Toward Site-Neutral Payment

A payment change in the OPPS final rule that aims to align payments made for services delivered in off-campus hospital outpatient departments with those made for services delivered in physician offices has raised considerable controversy.

Gail R Wilensky, PhD December 26, 2018

Time to Reassess: Keeping Up with Changes to CJR Target Pricing

Performance improvement targets have shifted again in the Comprehensive Care for Joint Replacement (CJR) program. Darcie Hurteau explains why participants should reassess their program strategies in light of this change.  

Darcie Hurteau October 2, 2018

4 Steps for Success in a Changing Payment Landscape

The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.

Charles Saunders, MD August 29, 2018
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