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At a Glance: What the Final Health Insurance Exchange Navigator Rule Means for Providers

Can hospitals and health systems serve as navigators or other assisters for the health insurance marketplaces? Here’s what the CMS final rule has to say.

HFMA July 31, 2013

CY14 OPPS Proposed Rule Fact Sheet

This fact sheet contains information on the proposed rule released by CMS updating payments to outpatient hospitals paid under the Medicare OPPS, and ambulatory surgical centers for CY14. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule with comment period that updates payment policies and rates for services furnished to Medicare beneficiaries in hospital outpatient departments and establishes payments for services furnished in ambulatory surgical centers (ASCs) beginning January 1, 2014. In addition, CMS proposes to update and refine the requirements for the Hospital Outpatient Quality Reporting Program, the ASC Quality Reporting Program, and the Hospital Value-Based Purchasing Program.

HFMA July 26, 2013

Overview of Medicaid Disproportionate Share Hospital Allotment Reductions

This document summarizes the proposed rule requiring reductions to state Medicaid disproportionate share hospital allotments required under the ACA from FY14 through FY20. CMS released a proposed rule requiring aggregate reductions to state Medicaid disproportionate share hospital (DSH) allotments. The rule, required by the Affordable Care Act (ACA), sets forth aggregate reductions to state Medicaid DSH allotments annually from FY14 through FY20. The proposed rule also delineates the DSH health reform methodology (DHRM) to implement the annual reductions for FY14 and FY15, and proposes to add additional DSH reporting requirements for use in implementing the DHRM.

HFMA June 27, 2013

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 June 20, 2013

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.

HFMA June 13, 2013

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.

HFMA June 13, 2013

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 June 13, 2013

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.

HFMA May 20, 2013

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 April 24, 2013

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.

HFMA April 15, 2013