Health plan-owned PCP clinics steer members to lower-cost sites-of-service
Hospitals and health systems need to be able to deliver high-quality outcomes in a cost-efficient manner to ensure they are not implicitly tiered out of a health plan's network.
HFMA gathering aims to arm CFOs for coming challenges
Inaugural HFMA Financial Sustainability Summit, April 16-17 in Denver, will bring together more than 200 hospital and physician practice CFOs to learn and share strategies.
Comprehensive Care for Joint Replacement Model Proposed Rule Detailed Summary
This document provides a detailed summary of the February 24, 2020, proposed rule published by CMS that would revise certain aspects of the Comprehensive Care for Joint Replacement model.
Supreme Court’s decision to wait to hear ACA challenge benefits Republicans
Democrats appear to have a strong advantage over Republicans in having gained public trust regarding healthcare policy, so it may be in Republication's interest to steer clear of discussions of healthcare in the time leading up to the November 2020 election.
Find the latest numbers and events shaping healthcare finance
Read about key events and the numbers shaping healthcare finance policy and practice in recent weeks.
CMS proposes extending mandatory bundled payment model for joint replacements
CMS plans to extend the Comprehensive Care for Joint Replacement program with modifications.
Comprehensive Care for Joint Replacement Model Proposed Rule Executive Summary
CMS released a proposed rule that would revise certain aspects of the Comprehensive Care for Joint Replacement model, including the episode of care definition, the target price calculation, the reconciliation process, the beneficiary notice requirements and the appeals process.
Many ‘failed’ federal healthcare quality programs need to end, analysts say
Experts on value-based payment say many federal programs have failed to produce results and need to be swept aside.
Fitch warns about a potentially big hit to NFP hospitals from Medicaid payment changes
The credit standing of not-for-profit hospitals could take a hit from proposed changes to aspects of Medicaid financing, according to a rating agency.
In response to providers, CMS offers further specifics about direct contracting
CMS officials further clarified the coming direct-contracting model during a series of discussions with providers.