Looking beyond CMS: How to accelerate the transition to value in healthcare
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.
Proposed CY 2021 Medicare Physician Fee Schedule changes: Analysis of impact on telehealth flexibilities and E/M coding
HFMA's Katie Gilfillan says the E/M coding changes taking place January 1, 2021, will have significant impacts not only to primary care physicians but also will have significant impact on specialist’s reimbursement.
What to expect from President Trump’s recent executive orders on drug prices
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.
Long-term fiscal impact of the of COVID-19 pandemic on the overall federal debt and Medicare Part A Trust Fund shortfall cannot be overlooked
Recommendations from healthcare economists for savings to preserve Part A Trust Fund focus more on taxes and less on providers.
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.
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.
Safety net hospitals could see increase in payments if CMS updates estimates of uninsured in 2021 IPPS final rule
HFMA's Chad Mulvany explains why a small percentage point increase in the uninsured rate could significantly impact the UC DSH dollars available to safety net hospitals at a time when they are financially struggling due to COVID-19.
Study: Medicare Advantage enrollees less likely than traditional Medicare enrollees to use both institutional post-acute care and home health care
HFMA's Chad Mulvany says where there is competition for PAC discharges, providers should partner with high-quality PAC providers.
State public option efforts waiver in face of the COVID-19 pandemic
HFMA's Chad Mulvany says although COVID-19 may have "dampened enthusiasm" for Washington state's public option, he is not sure the blame for its slow start rests solely, or even partly, on COVID-19.
Medicaid provider rate cuts forecast as states anticipate budget shortfalls
Because the CARES Act prohibits states that received increased funding from cutting benefits, increasing premiums or restricting eligibility, one of the few available options to reduce costs is making provider rate cuts.