Three Strikes Against the Idea that Coverage Reduces ED Use
Ken Perez describes three case studies showing that expanded coverage increases emergency department use.
How CMS Leveled the Playing Field for Hospital Readmission Penalties
A new rule finalized by CMS acknowledges that charging hospitals with higher percentages of dual eligibles the same readmission penalties as hospitals with fewer of these patients. The proposed penalty adjustment will reflect the challenges facing each hospital's populations.
Evidence-based Guidelines Can Lead ACOs Toward MACRA Success
Joe Guerriero describes opportunities for ACOs enrolled in Medicare programs.
Executive Summary: CMS 2018 IPPS Final Rule
HFMA summarizes the Centers for Medicare & Medicaid Services' 2018 Inpatient Prospective Payment System Final Rule.
Taking Control of Pay-For-Performance Contracts
To ensure their organizations perform effectively under risk contracts, healthcare finance leaders should implement a work plan to manage the contracts.
10 Critical Medicaid Trends to Watch
It is important for hospitals and health systems to forecast the impact of proposed healthcare legislation on Medicaid payments, eligibility teams, and patients.
Ask the Experts: Medicaid Billing
How should I bill New York Medicaid for services provided by non-hospital employee clinicians in emergency department settings?
Health Systems Brace for MACRA
Hospitals and health systems are working to help their physicians succeed under MACRA, which means moving quickly to advanced APMs.
CMS’s 2018 IPPS Proposed Rule and RFI: Signaling the Trump Administration’s Deregulation Agenda
Ken Perez describes the connection between the effort to repeal and replace the Affordable Care Act and a new proposed rule and request for information by CMS.
Alternative Payment Models at the State Level
In an effort to address rising healthcare costs, many states have implemented alternative payment models.