Health Plan Payment and Reimbursement

Supporters of releasing privately negotiated health plan rates dominate public comments

Supporters of a proposal for hospitals to release their health plan-negotiated rates, so far, have dominated comments on it to CMS.

Rich Daly August 31, 2019

Analysis: How a union’s plan could foreshadow changes in maternity care nationwide

HFMA’s Chad Mulvany reviews why he expects more employers to follow the lead of Local 32BJ’s and state Medicaid programs and implement both episodic payment models for pregnancy and non-payment for elective, pre-term C-sections.

Chad Mulvany, FHFMA August 28, 2019

Analysis: Proposed negotiated-rate posting requirements from the OPPS rule

HFMA's Chad Mulvany offers insight into the major issues associated with CMS’s proposed new requirement for hospitals to post negotiated rates.

Chad Mulvany, FHFMA August 28, 2019

Strategic Financial Planning Summer 2019 Issue

Read the Summer 2019 issue of Strategic Financial Planning.

HFMA August 22, 2019

University of Rochester: Using telemedicine to reach more patients with Parkinson’s disease

An academic medical center’s efforts to bring telemedicine to patients with Parkinson’s disease has reduced costs and improved outcomes.

Ray Dorsey, MD August 21, 2019

Enrollment of large-company workers in high-deductible plans reaches a historic high

The share of covered workers enrolled in high-deductible health plans (HDHPs) at large employers reached 47% in 2019.

Rich Daly August 14, 2019

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.

HFMA August 1, 2019

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.

Emad Rizk, MD August 1, 2019

A look at early hospital concerns over the proposed release of negotiated charges

National hospital advocates, individual executives and an industry adviser identified early concerns with the proposed mandatory release of hospital-negotiated charges.

Rich Daly July 31, 2019

OPPS rule to bring many hospital financial challenges — and a little help

The long-awaited Medicare proposed rule for hospital outpatient payments includes a high-profile mandate on hospitals to release rates negotiated with commercial health plans, among other regulations that could pose financial challenges. Several smaller provisions could help hospitals.

Rich Daly July 31, 2019
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