Health Plan Resources

A collection of resources to help health plan leaders navigate the challenges and opportunities in this new era of health care.

Resources

News | Value-Based Payment

CMS aims to spur value-based payment arrangements between drugmakers and insurers, including Medicaid
CMS says rule changes would allow more outcomes-based payment arrangements for Medicaid programs and commercial health plans.
By Rich Daly, HFMA senior writer and editor
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Blog | Healthcare Reform

House bill may provide insight into coverage priorities if White House and Senate flip in November's election
The best-case scenario for Democrats is to come out of election night with a 50-50 split of the Senate, which would allow them to pass a package of tweaks to the ACA, with the Vice-President (assuming Biden wins) casting the deciding vote.
By Chad Mulvany, FHFMA
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News | Value-Based Payment

Medicare reopens application period for Direct Contracting models
CMS opened the application process for Direct Contracting models to more providers.
By Rich Daly, HFMA senior writer and editor
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News | Value-Based Payment

CMS aims to spur value-based payment arrangements between drugmakers and insurers, including Medicaid
CMS says rule changes would allow more outcomes-based payment arrangements for Medicaid programs and commercial health plans.
By Rich Daly, HFMA senior writer and editor
Save
News | Value-Based Payment

Medicare reopens application period for Direct Contracting models
CMS opened the application process for Direct Contracting models to more providers.
By Rich Daly, HFMA senior writer and editor
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News | Medicare Payment and Reimbursement

Moody’s projects cash will be stable for rated hospitals through the summer
Federal assistance programs should stabilize hospital cash through the summer, when Medicare repayments will create major financial pressure.
By Rich Daly, HFMA senior writer and editor
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Blog | Healthcare Reform

House bill may provide insight into coverage priorities if White House and Senate flip in November's election
The best-case scenario for Democrats is to come out of election night with a 50-50 split of the Senate, which would allow them to pass a package of tweaks to the ACA, with the Vice-President (assuming Biden wins) casting the deciding vote.
By Chad Mulvany, FHFMA
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Blog | Payment Models

Intermountain Healthcare to provide hospital-at-home services for some higher-acuity patients

The move to hospital at home for higher-acuity patients by some health systems can create savings for their Medicare Advantage and other full risk products and for its Administrative Services Only clients.
By Chad Mulvany, FHFMA
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Blog | Population Health Management

Optum's naviHealth acquisition will help lower the total cost of care for UHC members and Optum physician practice patients
Optum's naviHealth purchase rounds out is capabilities, ensuring its UHC members — particularly MA members and Optum's practices' patients — receive the right care in the right setting at the right time post hospitalization.
By Chad Mulvany, FHFMA
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