Question: What are the most important Medicare resources that a new healthcare finance leader should obtain or subscribe to?
Answer 1: There are a few resources to consider. First, subscribe to the numerous listservs or e-newsletters from the Centers for Medicare & Medicaid (CMS), and with your local Medicare Administrative Contractor (MAC). (Here is the latest list of MACs.)
The CMS site has an Outreach and Education section that offers a number of different training options, including web-based training.
Other useful resources are your local and state hospital associations. They may also have listservs or email lists that keep you updated on the latest state and federal changes.
This question was answered by Caswell Samms, vice president of revenue cycle, St. Barnabas Hospital, and a member of HFMA’s Metropolitan New York Chapter (email@example.com).
Answer 2: The best introductory information on Medicare can be found in the product catalog of CMS’s Medicare Learning Network (MLN).
MLN produces booklets, brochures, fact sheets, quick reference guides, newsletters, and e-mail updates. It also offers web-based training and podcasts. The materials are well written, easy to understand, and free of charge. (Note: Don’t confuse MLN with MedLearn, a private company providing education.)
Sample MLN fact sheets that would be good for newcomers include:
MLN also has good information on the Medicare Shared Savings Program, accountable care organizations, and the Physician Quality Reporting System.
As Caswell Samms mentioned above, the MAC websites also present in-depth information on Medicare in a much more accessible way than the CMS site. A good starting place is the site map of Noridian Administrative Services, the MAC for Jurisdiction F.
A revenue cycle leader should also attempt to read, at least once in a lifetime, the IPPS, OPPS, and MPFS final regulations in the Federal Register.
Kaiser Family Foundation’s RSS feed is also an excellent source of up-to-date information on Medicare and many other topics, although it is easy to get overwhelmed by the sheer volume of information to be found there.
Finally, the finest source on healthcare financial management, including Medicare, is still hfm, HFMA’s monthly magazine.
This question was answered by Christoph Stauder, FHFMA, CPA, principal, Stauder Consulting, LLC, and a member of HFMA’s Oregon Chapter (firstname.lastname@example.org).
Answer 3: Check if your state hospital association works with major payers to ensure that reimbursement updates are sent to the member hospitals. The association may also bring the hospitals and payers together to address issues impacting payments, etc. Our state association has quarterly meetings with our Medicare fiscal intermediary, Medicaid, and all applicable state agencies, as well as with our major payers, like Blue Cross and some big commercials.
In addition, your hospital should have a provider representative from the fiscal intermediary who should be keeping leaders and staff abreast of changes as well.
Finally, you should, of course, reach out to your local HFMA chapter. Our chapter did a third-party payer meeting twice a year with all the major payers presenting updates and addressing issues.
This question was answered by Christine Fontaine, CHFP, CPAM, vice president of revenue cycle solutions, OptumInsight, and a member of HFMA’s Maryland Chapter (email@example.com).
Answer 4: If you’re not sure which CMS listserv or e-newsletter to sign up for, you might start with the weekly CMS Medicare FFS Provider E-news. It sums up all the main announcements from Medicare for the past week.
You can also follow CMS on Twitter to learn about any changes in the Medicare fee-for-service Program. If you search for the following hashtags on Twitter, you can identify information about specific updates or events:
- #CMSMLN for all MLN tweets
- #CMSNPC for all National Provider Call tweets
- #MLNProducts for all tweets related to MLN products
If you prefer RSS feeds, you can subscribe to CMS RSS feeds.
Finally, HFMA puts together summaries and fact sheets of major Medicare rules and regulations.
This question was answered by Maggie Van Dyke, managing editor, HFMA Forums (firstname.lastname@example.org).
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Publication Date: Thursday, January 24, 2013