Healthcare Reimbursement

Congress is still expected to pass a surprise-bill measure this year

Congress is likely to enact surprise-bill legislation in the waning days of 2019, according to policy advisers.

By Rich Daly November 22, 2019

Analysis: How traditional healthcare providers can compete with innovators and progressive incumbents

Providing high-quality and cost-efficient services is the first step traditional healthcare providers must take to stave off business disruption by new entrants and progressive incumbents into the market.

By Chad Mulvany, FHFMA November 22, 2019

Nov. 25-29: CMS comment deadlines are among the week’s healthcare finance events

Deadlines to comment on various CMS initiatives affecting hospitals are among the major healthcare finance events taking place the week of Nov. 25.

By Rich Daly November 21, 2019

Health Plan Price Transparency Requirements Proposed Rule Executive Summary

On November 15, 2019, CMS issued a proposed rule that, if finalized, would require health plans to make an online price transparency tool that provides cost sharing and other information available to their members.

By HFMA November 21, 2019

Analysis: Hospital at home will move inpatient admissions into the home

Acute care providers must analyze the risks and opportunities of participating in the at-home-hospital model of patient care.

By Chad Mulvany, FHFMA November 20, 2019

One health system finds ‘millions’ of reasons to audit value-based payments

A health system identified millions of dollars in underpayments that it should have received as part of two value-based payment arrangements in recent years.

By Rich Daly November 19, 2019

How one ACO leveraged universal truths of value-based contracting for success

A finance leader of successful East-coast accountable care organization describes the key factors that have enabled the ACO to thrive under value-based payment contracts.

By Eric C. Reese, PhD November 18, 2019

Administration finalizes requirement for hospitals to post rates paid by health plans

A newly finalized requirement will require hospitals to post rates that are privately negotiated with health plans, as well as rates for a list of 300 “shoppable services.”

By Rich Daly November 15, 2019

White House healthcare leader expresses skepticism of mandatory models

The Trump administration’s healthcare policy leader was openly skeptical about further use of mandatory payment models after Medicare has added several in recent years.

By Rich Daly November 14, 2019

Why the Trump administration is pursuing hospital payment cuts that courts have rejected

The Trump administration is continuing to push hospital payment cuts rejected by courts to make the case to Congress that new laws are needed, according to a senior White House official.

By Rich Daly November 13, 2019
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