CMS and MedPAC Guidelines and Trends

5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission

Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.

HFMA August 29, 2018

Number of MSSP ACOs and Shared-Savings Characteristics

The number of ACOs participating in the Medicare Shared Savings Program increased at a faster rate from 2013 to 2018 than did the number of participants that achieved shared savings in the first four years of the program.

HFMA July 27, 2018

Who’s Afraid of a Little Risk?

The Medicare ACO modeled advanced by CMS has encountered some challenges, but it still holds promise if CMS addresses the flawed idea of retrospective attribution of patients to an ACO.

Jeff Helton,  PHD, FHFMA, CMA, CFE July 3, 2018

Value-Based Care Is a Better Investment for Everyone

Griffin Myers explains the value of value-based care.

Griffin Myers May 24, 2018

CMMI’s “New Direction” Comments Indicate Enthusiasm of Healthcare Stakeholders

Dave Terry describes how feedback to a CMS announcement last fall has spurred another request.

Dave Terry May 22, 2018

Ask the Experts: Calculating Contract DRGs

What is a simple way to accurately determine my current base DRG rate?

HFMA May 9, 2018

The Study of Factors Influencing the Total Cost of Health Care

A study conducted by HFMA, Leavitt Partners, and McManis Consulting investigated factors driving the total cost of health care in the United States.

HFMA April 25, 2018

MA Ruling May Signal Industry Readiness to Integrate SDH into Traditional Medical Care

In addressing social determinants of health and social services, a recent Medicare Advantage ruling by CMS may have taken the first steps toward providing more integrated and comprehensive care to the nation’s aging population.

Gail R Wilensky, PhD April 25, 2018

The Current Outlook for Value-Based Care Under the Trump Administration

Value initiatives introduced by the Affordable Care Act have met with varied success. Under the Trump administration, the future of these initiatives is uncertain.

Ken Perez April 25, 2018

The Future of VACs: Valuation and Strategic Considerations

Recent changes to the Medicare Physician Fee Schedule may make it financially advantageous for vascular access centers operating under an extension-of-practice model to shift their operations to an ambulatory surgery center setting.

Brad Brumbaugh March 6, 2018
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );