Medicare Payment and Reimbursement

Why it can be a good idea for hospitals to stand up to government policy

Healthcare finance executives in the United States can take a lesson from an eye-opening book by Ted Giovanis, FHFMA, MBA, Beyond fear: How I fought the feds for six years — and won.   In this book, Giovanis, a long-standing member of HFMA’s Maryland Chapter, chronicles how he identified an error in an arcane Medicare formula…

Walter Unger November 18, 2022

Final regulations for rural emergency hospitals set the stage for first year of eligibility

REHs will be reimbursed for providing emergency care and outpatient services and must abide by terms and conditions that include limiting average length of stay to 24 hours.

Nick Hut November 18, 2022

Changes to reimbursement for 340B drugs reverberate in the 2023 final rule for Medicare outpatient payments

The Medicare payment rate for hospital outpatient services will increase significantly in 2023, but the net gain will be quite a bit less than is apparent at first glance.

Nick Hut November 2, 2022

Paul Keckley: 2 major changes in the value agenda require finance leaders’ attention

The value agenda in U.S. healthcare is critical to its future, but there are two key areas in which it is likely to be redirected in years to come.

Paul H. Keckley, PhD October 2, 2022

Rethinking population health management: Why successful risk-based contracting requires provider empowerment

Find out how one company hopes to solve challenges of industry shifts from fee-for-service to value-based care by reversing the long-standing narrative that population health management isn’t possible or profitable.

HFMA September 30, 2022

Medicare payments for 340B drugs are set to increase immediately after recent court ruling

The Medicare payment rate for drugs acquired through the 340B program must be increased by nearly 30 percentage points effective immediately, according to a court ruling.

Nick Hut September 30, 2022

News Briefs: Financial and operational challenges still hamper hospitals 2.5 years into the pandemic

As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.

Nick Hut September 29, 2022

Healthcare News of Note: UnitedHealth Group can proceed with Change Healthcare purchase after a favorable decision in an antitrust case

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: UnitedHealth Group cleared to acquire Change Healthcare, standard patient satisfaction surveys need to address DEI issues, and homebound older adults contribute to higher levels of Medicare spending.

Deborah Filipek September 26, 2022

Recent changes to E/M coding mean time-based billing could be advantageous for longer visits, study finds

Depending on patient volumes, clinics could benefit from incorporating time-based billing instead of relying on CPT coding approaches.

Nick Hut September 11, 2022

Hospitals can recover all eligible Medicare bad debts by automating the Medicare bad debt review process

One company addresses the challenges of complex rules regulating Medicare bad debt processes and reporting, which makes payment recovery for hospitals difficult.

HFMA August 31, 2022
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