Payment Models

Lessons learned from the transition from volume to value

To effectively transition to value, ACO must fully grasp the success factors that will determine future success under value-based payment, including success with downside risk. A research study examined key organizational, financial, market and other characteristics that support the decision to take on risk.

Bonnie B. Blanchfield, CPA, ScD November 25, 2020

Hospitals and health systems remain optimistic, overall, about APMs

An August HFMA survey, sponsored by GHX, found that, overall, hospitals and health systems are optimistic about seeing improvements in coordination and collaboration with partners in risk-based payment models over the next five years. The findings suggest organizations are moving ahead unabated in their value-based payment strategies.

Eric C. Reese, PhD November 24, 2020

California v. Texas: What’s next?

HFMA's Chad Mulvany says we won’t know the outcome of the case until sometime in the first half of next year.

Chad Mulvany, FHFMA November 10, 2020

Home health provider looks to scale hospital-at-home model

HFMA's Chad Mulvany says this capability positions Dispatch Health as an ideal partner to Medicare Advantage plans or PCPs in risk-sharing models with MA plans, to reduce the total cost of care while maintaining high-quality outcomes.

Chad Mulvany, FHFMA October 28, 2020

Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions

HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.

Chad Mulvany, FHFMA October 22, 2020

Major insurers roll back no-cost sharing telehealth services

HFMA's Chad Mulvany says patients who received a surprise bill for a telehealth visit will likely blame the provider.

Chad Mulvany, FHFMA October 7, 2020

How to lay the foundations for success under CMS’s new MDC program

The CMS Medicare Direct Contracting (MDC) program offers hospitals and health systems a unique opportunity take the next step in value-based payment and population health management. Success requires the right targeted investments in expertise and infrastructure.

Allen Miller, MPH September 28, 2020

Rand releases updated study of hospital payment variation in commercial market

HFMA's Chad Mulvany says it’s imperative that everyone in the U.S. supports safety-net hospitals, or there will be an increase in the disparities in access to basic healthcare services between the haves and have-nots.

Chad Mulvany, FHFMA September 25, 2020

Increased ACA uncertainty at the U.S. Supreme Court upon death of RBG

HFMA's Chad Mulvany says given the Supreme Court’s historically narrow view on severability, many legal experts doubt the court, even with its new makeup, will overturn the entirety of the ACA.

Chad Mulvany, FHFMA September 24, 2020

CMMI announcement foreshadows more mandatory bundled payment models

HFMA's Chad Mulvany says based on recently announced changes to BPCI-A episodes, a mandatory model may be defined much broader than currently.

Chad Mulvany, FHFMA September 17, 2020
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