The following contains information on new initiatives, ongoing projects, and other related news about and from HFMA. Please bookmark this page as it will be updated periodically.
HFMA's Regulatory Sound Bites: An Overview of the Final 2014 IPPS Rule
This presentation contains noteworthy information on the FY14 payment updates for hospitals under the IPPS.
View the presentation
HFMA Submits Comments on the Medicare RAC Program
HFMA describes its concerns relating to: quality, alignment, fairness/sustainability, simplification, and societal benefit.
Read our comment letter.
Value-Based Reimbursement Resource
This set of tools contains important information about CMS's Value-Based Purchasing Program, Hospital Readmissions Program, and Hospital Acquired Conditions.
Patient Financial Communications
HFMA has announced consensus practices to bring consistency, clarity, and timeliness to patient financial communications.
Get more information and view the best practices.
Hospitals' Marketplace Enrollment Efforts Hit Snags
Hospitals across the country that were supposed to lead the enrollment of beneficiaries through new health insurance marketplaces had limited early success in doing so due to technological failings and other obstacles—and at press time, it remained to be seen whether a fix could be implemented quickly.
Hospitals have responded by signing up as both "navigators" and certified application counselor (CAC) organizations—both of which require federal training and certification to begin signing applicants up for coverage.
In August, eight hospitals and health systems were among 105 organizations nationwide to receive the navigator designation, which came with federal funding to hire temporary personnel trained to steer the uninsured to insurance coverage.
But in the days following the Oct. 1 start date for the 2014 enrollment period, highly publicized technical failings of the federal and state marketplace enrollment websites blocked the navigators as thoroughly as they blocked the public. At press time, federal officials said the technical failings were temporary and expected the website to become fully functional by November.
The problems also affected CAC organizations, which are similarly certified as navigators to provide enrollment assistance, but without any federal funding.
At press time, the extent of the enrollment problems at the federal level remained unknown even as CMS touted 8.6 million visitors to the federal website in the first three days of enrollment. Those figures came as CMS declined to provide enrollment figures—including navigator and CAC enrollment—until at least November, according to a CMS spokesman.
Hospital Lawsuit Underlines Provider Concerns with Marketplace Plans
Seattle Children's Hospital has filed suit against the state of Oregon's insurance regulator for approving few marketplace plans that include it as a preferred provider.
The lawsuit may be among the first legal moves by a provider excluded from the narrow provider networks that dominate among plans in the new health insurance marketplaces.
Those narrow networks frequently exclude higher-cost providers, such as academic medical centers and children’s hospitals. Enrollees who seek care at non-network providers could bear a significantly higher share of the cost of their care.
Most health plans sold through Oregon’s new health insurance marketplace exclude Seattle Children’s from their lists of in-network providers. The limitation, according to the hospital, could have an impact on the ability of parents to obtain or afford specialty care provided by the only pediatric hospital in King County and the only provider of many specialized pediatric services in the area, including acute cancer care, level IV neonatal intensive care, and heart, liver, and intestinal transplantation.
Hospitals officials worry that parents may enroll in health plans through the exchange without realizing that Children's is not included in the plan’s network.
Publication Date: Friday, November 01, 2013