Payment Trends

Maryland TCOC: A grand demonstration continues

As Maryland's Medicare Total Cost of Care priogram enters its second year, it It is a goodtime to revisit the program to understand its essential elements and implications for the nation's healthcare system.

Dale N. Schumacher, MD, MPH January 2, 2020

Hospital price study draws pushback

The dramatic conclusion of new research that hospitals prices are more than 200 percent of Medicare rates is raising questions among industry analysts.

Rich Daly December 23, 2019

How Montana got hospitals to accept Medicare-based payment rates

Montana moved its hospitals to Medicare-based payment rates to help reduce costs for its state-employee health plan.

Rich Daly December 20, 2019

‘Medicare for All’: What would it really mean for healthcare stakeholders?

“Medicare for All” would have varying impacts on hospitals, physicians and health plans but would be expected to cause financial hardship in the majority of cases.

Richard Rollo December 19, 2019

‘We were completely wrong’: How Henry Ford Health System won a major direct contract

How one health system won a large direct contract as such arrangements become more widespread.

Rich Daly December 16, 2019

7 keys to engaging physicians for success under BPCI-A

Physician engagement is a critical success factor for health systems that are pursuing bundled payment initiatives.

Douglas Ardoin Jr., MD, MBA December 16, 2019

Bipartisan policy group aims to slash hospital budgets

A group of policy advisers, researchersa nd politicians are urging a range of measures to cut spending on hospitals.

Rich Daly December 13, 2019

Why initiate health plan contract testing?

Various circumstances require providers to prepare for the impact of payment changes.

Lauree E. Handlon, FHFMA, RHIA, CRCR December 13, 2019

How to use contract testing and analysis to prepare for payment change

Whether a contract is new or up for renewal, a thorough understanding of the financial implications of changes to provider-payment terms is vital for continued operations.

Lauree E. Handlon, FHFMA, RHIA, CRCR December 13, 2019

OPPS final rule keeps site-neutral payments and 340B cuts; finalizes transparency requirements separately

The controversial major hospital payment cuts in the Outpatient Prospective Payment System (OPPS) final rule were retained from the proposed rule even though hospitals successfully have challenged them in federal court.

Rich Daly December 12, 2019
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