CMS seeks healthcare provider comments on possible new methodology to calculate MS-DRG weights
HFMA's Chad Mulvany reviews possible technical and legal challenges CMS may face as it proposes to collect provider pricing data.
Key hospital provisions and some questions requiring resolution from the CARES Act
Summary of the top five CARES Act provisions impacting hospital finances and the open questions associated with those provisions.
Will the value-based movement be re-energized in the wake of the coronavirus pandemic and its impact on national health expenditure?
HFMA's Chad Mulvany says he hopes healthcare payers and providers will be able to use the coronavirus crisis and the resulting impact on the national health expenditure as a catalyst to revive the value-based movement.
Risk-based contracting in the time of coronavirus
The APM target prices/benchmarks are among the many policy issues beyond paying for surge capacity that CMS, commercial health plans and providers will need to work through in the wake of the coronavirus outbreak.
State legislators roll back Indiana hospital bill that could have cut payments to hospitals
Health plans seeking state legislative help with site-neutral payments will likely find allies among employers who are increasingly frustrated with healthcare costs.
How long will employers continue to tolerate healthcare cost growth in excess of inflation?
Employer frustration with high healthcare costs is translating into support for more aggressive governmental intervention in healthcare markets.
Health plan-owned PCP clinics steer members to lower-cost sites-of-service
Hospitals and health systems need to be able to deliver high-quality outcomes in a cost-efficient manner to ensure they are not implicitly tiered out of a health plan's network.
What to expect from Medicaid block grant waivers
HFMA's Chad Mulvany says the macro design choice that matters to most to providers in any state that adopts the block grant program will be whether the state chooses the true block grant financing option, or if it selects a per capita cap based on the prior year’s enrollment.
The yin-yang of Medicaid: Expected federal regulations will increase number of uninsured despite increase in states taking expansion dollars
Despite more states considering taking Medicaid expansion dollars, federal regulatory efforts may drive an acceleration in the number of uninsured.
Limited BPCI savings seen with joint replacement bundles
CMS’s new BPCI-A model incorporates patient complexity into the risk-adjustment mechanism, but it remains to be seen if it will solve all issues with the previous model.