Payment, Reimbursement, + Managed Care

Stage 2 Meaningful Use Final Rule Key Dates

This document contains tables with useful dates and timelines pertaining to Stage 2 meaningful use criteria published in the September 4, 2012, final rule.
RY10 Inpatient Psychiatric Facility PPS Payment Update Fact Sheet

CMS has published a notice increasing Medicare payments to inpatient psychiatric facilities for rate year 2010. These changes, which are effective July 1, 2009, apply to IPF discharges occurring on or after July 1, 2009, through June 30, 2010.
Hospital Readmissions Reduction Program Overview

This fact sheet dicusses aspects of the Hospital Readmissions Reduction Program, as mandated by the Affordable Care Act (ACA).
Hospital Inpatient Value-Based Purchasing Program Fact Sheet

This fact sheet includes updates to the hospital inpatient value-based purchasing program developed by CMS to reward hospitals for meeting certain performance standards established for a performance period.
FY10 Inpatient Rehabilitation Facility PPS Final Rule Fact Sheet

The final rule includes updates to the case-mix group (CMG) classification and weights, facility-level adjustment factors, high-cost outliers, and the rescission of an outdated HCFA rule establishing the Medicare coverage criteria for IRF services.
Medicare Prescription Drug, Improvement, and Modernization Act

This document provides the full text of the Medicare Prescription Drug, Improvement, and Modernization Act.
Quality- and Severity-Based Payment: Will You Receive What You Earn?

In this roundtable, industry leaders discuss how pay for performance programs and severity based payment adjustments may impact healthcare facilities.
FY10 Skilled Nursing Facility PPS Payment Update Final Rule Fact Sheet

CMS published a final rule updating Medicare payment rates under the prospective payment system to skilled nursing facilities for fiscal year 2010. The payment rates are applicable for services provided by SNFs beginning October 1, 2009.
Hospital Strategies for Communicating Pricing and Quality

This report discusses some of the trends toward price and quality transparency and features strategies for communicating pricing and quality that actual hospital executives are employing as well as their advice to others.
Demonstration Project Compendium

Provides an overview of physician and hospital payment demonstration projects sponsored by private sector organizations and CMS.
Affordable Health Insurance Exchanges Proposed Rule Highlight

HHS issued a proposed rule implementing the new affordable insurance exchanges (Exchanges) mandated by the Affordable Care Act (ACA) that will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.
Bundled Payments for Care Improvement Initiative Fact Sheet

CMS announces its request for applications for providers to test episode-based payment for care using bundled payment methods under the Bundled Payment for Care Improvement initiative.
CMS Shared Savings/Loss Calculator

This spreadsheet, based on the CMS proposed shared savings rule, can be used to calculate potential shared savings/losses from forming a Medicare ACO.
FY12 Hospital Readmissions Reduction Program

In the FY12 IPPS final rule, CMS outlines the requirements of the hospital readmissions reduction program that it intends to implement in the FY12, FY13, and future IPPS LTCH PPS rulemaking cycles. Provided is the section of the FY12 IPPS
State Implementation of Health Insurance Exchanges

This resource provides a way to track the actions that states are taking to implement health insurance exchange development.
Stage 2 Meaningful Use of Certified Electronic Health Records Technology Proposed Rule Summary

This summary describes the stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to qualify for Medicare and Medicaid electronic health record incentive payments.
HFMA's Bundled Payment Resource Page

Below are links to bundled payment resources CMMI Bundled Payment Freeware Analysis Package View the resource for developing bundled payment bids.
Key Questions to Prepare for Health Insurance Exchanges

This tool provides questions to help prepare your organization for health insurance exchanges.
Health Insurance Exchange Resources

HFMA has compiled a resource catalog of content related to the proposed health insurance exchange regulations and the Essential Benefits Bulletin.
ACO Comparison Table: Proposed vs. Final Rule

This table from CMS outlines the differences between the Proposed Rule and the Final Rule for Accountable Care Organizations in the Medicare Shared Savings Program.
Brace for the Impact or Embrace the Impact?

This roundtable discusses how new payment models are going to impact the revenue cycle and how organizations plan to prepare for new market realities.
Are You Optimizing Your Contract Performance Data?

In this roundtable, senior financial executives discuss their top strategies for selecting metrics and ways they are optimally using performance data to implement revenue cycle change and improve payer compliance.
HFMA ACO Resources Page

HFMA comments on CMS's proposed rule on Medicare Shared Savings Program: Accountable Care Organizations.
Investing in Value: Business Models, Intelligence and Risk

During HFMA's recent Thought Leadership Retreat, participants explored how healthcare providers can develop the key competencies needed to succeed under value-based business models.
Real-World Value Initiatives

In this session, Mr. Lawson will discuss novel, value-based payment arrangements that Baptist Health South Florida is pursuing, not only with payers and physicians, but also with sovereign governments.

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Payment, Reimbursement, + Managed Care

Stage 2 Meaningful Use Final Rule Key Dates

RY10 Inpatient Psychiatric Facility PPS Payment Update Fact Sheet

Hospital Readmissions Reduction Program Overview

Hospital Inpatient Value-Based Purchasing Program Fact Sheet

FY10 Inpatient Rehabilitation Facility PPS Final Rule Fact Sheet

Medicare Prescription Drug, Improvement, and Modernization Act

Quality- and Severity-Based Payment: Will You Receive What You Earn?

FY10 Skilled Nursing Facility PPS Payment Update Final Rule Fact Sheet

Hospital Strategies for Communicating Pricing and Quality

Demonstration Project Compendium

Affordable Health Insurance Exchanges Proposed Rule Highlight

Bundled Payments for Care Improvement Initiative Fact Sheet

CMS Shared Savings/Loss Calculator

FY12 Hospital Readmissions Reduction Program

State Implementation of Health Insurance Exchanges

Stage 2 Meaningful Use of Certified Electronic Health Records Technology Proposed Rule Summary

HFMA's Bundled Payment Resource Page

Key Questions to Prepare for Health Insurance Exchanges

Health Insurance Exchange Resources

ACO Comparison Table: Proposed vs. Final Rule

Brace for the Impact or Embrace the Impact?

Are You Optimizing Your Contract Performance Data?

HFMA ACO Resources Page

Investing in Value: Business Models, Intelligence and Risk

Real-World Value Initiatives

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