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Medicare Disproportionate Share Hospital Payment Adjustment Fact Sheet
This document summarizes the major changes to the disproportionate share (DSH) payment adjustment that hospitals serving a significantly disproportionate number of low-income patients can qualify for, as outlined in the FY14 IPPS proposed rule.
HFMA Executive Survey: Hospital-Physician Affiliation
HFMA recently surveyed hospital CFOs and other senior-level executives about their views on physician employment and alternatives, such as clinical-comanagement arrangements, professional service arrangements, and joint ventures. Topics explored in the research, which was sponsored by McKesson, include projected business landscape, physician employment's role in value-driving efforts, and preferred models for physician performance management.
Tool: Service Line Planning Annual Calendar
Mission Hospital recently revamped and streamlined its service line planning approach, assigning specific tasks to specific months of the year.
Tool: Physician Practice Assessment and Checklist for Optimization
Healthcare leaders can use this assessment tool to determine how to improve medical group efficiency and performance.
HFMA Comments on Medicare Part B Inpatient Hospital Billing and the RAC Program
HFMA is concerned with aspects of the RAC program that violate many of HFMA’s principles of a reformed payment system. Comments focused on rebilling for medically necessary services and the timeframe.
Successfully Negotiating Managed Care Contracts
“The more an organization solidifies its own expectations for contract negotiation and appreciates the needs of the payer, the more likely it is to reach an acceptable agreement,” says Paula Dillon, director of managed care for Rockford Health System.
HFMA Comment Letter: Second Draft of Sustainable Growth Rate Repeal & Reform Proposal
Read HFMA's comments to the chairs of the House of Representatives' Ways and Means and Energy and Commerce Committees and their respective Health Subcommittees on their drafted framework for legislation to replace the SGR.
Patient Friendly Billing Resources
Patient Friendly Billing Resources Here is an extensive list of patient friendly billing reports, analysis, tools, case studies, and related information.
HFMA Comment Letter: Medicare Program: Request for Information on Clinical Quality Measures Reporting
HFMA comments to CMS on its efforts to simplify requirements for physician quality reporting. HFMA supports efforts to better align CMS policy with HFMA's core payment reform principles.
Medicare Part B Inpatient Billing in Hospitals Proposed Rule Fact Sheet ;reasonable and necessary;Medicare Part A claim denial;inpatient admission
This fact sheet highlights the CMS's proposed rule, Medicare Program; Part B Inpatient Billing in Hospitals, which would revise the current billing policy under Medicare Part B following a denial of a Medicare Part A inpatient claim for services not reasonable and necessary.