Healthcare Reform

Capitol Dome ImageReform Resources

Pursuing Bundled Payments: Lessons from the ACE Demonstration

Participants in CMS's ACE demonstration project share strategies and tactics for participating in bundled payment initiatives. 

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Investing in Value: Business Models, Intelligence, and Risk 

Participants of HFMA’s Thought Leadership Retreat explored how healthcare providers should develop the key competencies required to succeed under value-based business models.

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ACO Final Rule Executive Summary and Section Highlights

This document provides a summary of CMS's shared savings program final rule and highlights the rule's changes by section.

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Pioneer ACO Model

This document provides noteworthy highlights of what the Pioneer ACO Model is and details of shared savings options.

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Legal Challenges to Healthcare Reform Legislation

A number of states have filed lawsuits against the government citing unconstitutionality of certain parts of the legislation. Follow the outcomes of these individual lawsuits.

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HFMA Comments on Proposed Readmissions Reduction Program

Read HFMA's commentary to the CMS on the proposed Hospital Readmissions Reduction Program in FFY12 IPPS Rule.

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Readmission Reduction Program Tool

Use a tool developed by CBIZ KA Consulting Services, LLC that allows organizations to see how their facility is affected by the Readmission Reduction Program.

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HFMA Summary of Key Provisions in Healthcare Reform Legislation

On March 30, 2010, President Obama signed the Health Care and Education Reconciliation Act of 2010, the final piece in Congress’s healthcare reform legislative package. This summary highlights key provisions of the healthcare reform legislation that impact providers.

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Timeline of Key Reforms and Implementation Dates

See the five-year implementation plan for key reform provisions.

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Tools

Physician-Hospital Integration. In its most recent payment reform project white paper, HFMA identifies physician-hospital integration as a key competency for success under reform. View a checklist of integration strategies. 

Charity Care and Community Benefit. Health reform legislation places new community benefit and financial assistance requirements on tax-exempt providers. Use these tools to:

CMS Shared Savings/Loss Calculator. This spreadsheet, based on the CMS final shared savings rule, can be used to calculate potential shared savings/losses from forming a Medicare ACO.
 

HFMA’s Payment Reform Project White Papers

Since September 2007, HFMA has led a payment reform thought leadership initiative to identify the principles that should guide changes to the current healthcare payment system and the competencies that providers will need to succeed under reform. The initiative’s findings and recommendations are summarized in these white papers:

Integration in a Reform Environment: Strategies for Success (June 2010)

Collaboration between hospitals and physicians will be critical as the nation moves toward healthcare reform. Learn key strategies for effectively implementing integration, based on findings from HFMA's 3rd Annual Thought Leadership Retreat.

Healthcare Payment Reform: Accelerating Success (February 2010)

This white paper identifies integration, risk management, pricing, and competencies related to quality, cost, and value as the keys to success under payment reform.

Healthcare Payment Reform: A Call to Action (June 2009)

This white paper identifies competencies in three key areas that providers can begin to build today to succeed under payment reform.

Healthcare Payment Reform: From Principles to Action (Sept. 2008)

Our current payment system works against the actions needed to improve health care. This paper outlines the principles, actions, and collaborative approach that is needed to transform the payment system.
 

Additional  Resources

This HFMA Compendium, "Bundled Payments: An Opportunity Worth Pursuing?" brings together a group of recent articles from HFMA publications exploring potential benefits and risks in bundled payments, as well as strategies and tips for organizations that decide to pursue bundled payment opportunities.

HFMA's ACO Compendium is a compilation of articles and resources that presents a variety of perspectives on ACOs.

The Commonwealth Fund's Health Reform Resource Center provides a timeline and summary of key provisions in the Affordable Care Act.

HFMA Comments on Attributes of Tax-Exempt Healthcare Providers 

In this June 18, 2009, comment letter to Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, HFMA encourages moving away from a narrow focus on charity care in discussions of not-for-profit hospitals’ tax-exempt status.

Are You Ready for Value-Driven Health Care? 

Value-focused reforms to today’s payment system are sure to be a major component of healthcare reform, and providers need to be prepared. This HFMA educational report describes how providers are using new pricing structures, physician alignment strategies, and healthcare IT to enhance the value and quality of care.

Webinars 

View our current webinar offerings for sessions on the various impacts of healthcare reform.

HFMA’s Healthcare Financial News 

Stay up to date on the latest healthcare reform developments on HFMA’s Healthcare Financial News blog.

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HFMA Summary of Proposed ACO Rule
HFMA Summary Proposed of ACO Rule

Read HFMA's summary of CMS's proposed ACO rule including proposed quality metrics and supplemental tables. 

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