Physician Practice Resources

Most BPCI-A participants will see major changes in 2021 ahead of a mandatory model in 2024, CMS says.

Hospitals plan to continue moving to value-based payment despite obstacles to caring for patients under risk-based contracts amid the COVID-19 pandemic.

In the FY21 IPPS final rule, CMS expanded controversial negotiated-price reporting requirements.

Employer-sponsored health plans are pausing value-pay expansions in favor of adding virtual care options in response to the COVID-19 pandemic, according to a business group survey..

A new rural payment model will test capitated and ACO payments and could encourage major changes in hospital business models.

The CY21 OPPS proposed rule would eliminate the inpatient-only list of services over three years while increasing the number of ASC-eligible procedures, and also would increase 340B payment cuts and overhaul the hospital star-rating system.

HFMA's Chad Mulvany offers insight on key areas of the Inpatient Prospective Payment Service final rule, including market-based MS-DRG weights, Uncompensated Care DSH and Medicare bad debt requirements.

HFMA's Chad Mulvany summarizes a blog on actions CMS and Congress can take to transition providers to capitated and other risk-bearing payment models.

HFMA's Chad Mulvany says the Most Favored Nation pricing executive order faces long odds of becoming an enforced policy because it faces significant opposition from three of the most influential lobbies in Washington, D.C.

HFMA's Chad Mulvany says patients and consumers need information that’s relevant to their specific clinical situation and out-of-pocket costs for price and quality information to be meaningful.

HFMA's Katie Gilfillan says the time may be right for a re-orientation of the healthcare system, where hospitals, physician groups and purchasers of care along with payment models are aligned to support a more patient-centric system.

Given Congress is unlikely to provide a surprise bill fix prior to the election, Chad Mulvany suggests hospitals provide patients with HFMA's consumer guide on avoiding surprise bills to learn what questions to ask prior to any scheduled s...