Hospital payment cuts fund state public-option plans
States are using hospital rate cuts as a key building block to support a growing number of public-option health plans.
How a ‘mini-Optum’ saved $85 million in three years by emphasizing primary care
A Texas clinically integrated network has used a primary care physician-focused approach to lower healthcare spending by $85 million over three years.
More Medicaid programs increase hospital payment rates
More states have moved to increase hospitals’ Medicaid rates than to cut them — reversing a pattern from the last fiscal year.
Physician Self-Referral Proposed Rule Summary
This document summarizes the proposed rule updating regulations implementing the physician self-referral law, published by CMS in the October 17, 2019, Federal Register.
Oct. 19-25: CMMI leader to address value-based care executives
Healthcare finance policy events for the week of Oct. 21 include an address from a CMMI executive, HFMA webinars and a deadline for comments on advance beneficiary notices.
Allocating capital to medical technology in the age of value-based payment
As value-based payment and risk-bearing contracts become more prevalent, hospital leaders will be incentivized to incorporate methods that provide increased transparency and evidence into whether a technology improves patient outcomes at the lowest possible cost of care.
Addressing the largest area of healthcare waste requires plans and providers to collaborate
Plans and providers should work together to systematically catalog the biggest administrative complexities responsible for unnecessary healthcare spending and develop a standardized approach to reduce or eliminate them.
Provider alignment to get a boost under anti-kickback, Stark proposals: attorney
Provider initiatives to better align under value-based payment models would get a boost from proposed Stark and anti-kickback law enforcement changes.
Cup of Joe: Matt Eyles, CEO of AHIP
America's Health Insurance Plan President and CEO Matt Eyles discusses how health plans view price transparency and other issues facing the industry.
Special Episode: CMS transparency effort misses the mark
On the day that public comments were due to CMS on its proposed rule that would require the controversial public release of rates hospitals negotiated with health plans, Joe Fifer, president and CEO of HFMA, and Chad Mulvany, director of health finance policy and analysis for HFMA, preview their comments to CMS. Learn about the promise and peril of the approach CMS is taking to this key transparency issue.