3 starter steps for health systems pursuing value-based contracts
A health system's ability to succeed under any of the new Medicare value-based payment programs will depend on how effectively it meets 3 strategic imperatives for effective performance in risk contracts.
Navigant Consulting, Inc.: Hospitals and Health Systems Prepare to Assume More Risk
: This research highlight discusses key takeaways from a May 2019 HFMA study of hospital and health system senior financial executives about their organizations’ interest in and capabilities for assuming risk.
Revenue Cycle Strategist June 2019
HFMA's Revenue Cycle Strategist newsletter June 2019 issue features articles on value-based payment, coding and Medicaid regulations.
Provider Risk Readiness Report
The results of a May 2019 HFMA study about risk readiness in which hospital and health system senior financial leaders share insights on their organizations’ risk capabilities and tolerance.
The price of precision medicine: 3 ways for health plans to manage genetic-testing costs
With spending on genetic testing expected to grow significantly, health plans can use three steps to get a handle on costs.
Pursuing a Proactive Denials Strategy Helps Resolve Denials and Prevent Recurrence
A look at how one company is partnering with healthcare organizations to use data and technology to address the root causes of long-standing problems, including denials.
Ensuring value-based data sharing complies with HIPAA
Healthcare organizations engaging in value-based contracts may be at greater risk for a breach if patient privacy and HIPAA are not front and center.
Analysis: Local purchasing alliance reduces hospital prices by 20%
As more data on price variability in healthcare becomes available, there will be an increase in activist employers and employer coalitions getting local health systems to lower prices.
Ask the Experts: Contract performance
My organization recently transitioned to its first Ambulatory Payment Classifications (APC)/DRG-based contract with a commercial plan. We are struggling with determining how to monitor the contract’s performance and, in particular, with the primary focus on the APC payment. Are there recommended key performance indicators (KPIs) used to track this performance? Answer: It is likely that your organization…
How to refine medical record sharing to mitigate risk and improve productivity
Careful review of medical record sharing costs and responsibilities stated in managed care contracts can reduce providers' expenses and productivity burden during payer reviews and audits.