Healthcare Reimbursement

Articles covering payer reimbursement, managed care, payment models, revenue optimization, and healthcare payment policy changes.

Kaiser ramps up SDOH spending, but a demonstrable ROI is likely ‘years’ away

Kaiser Permanente is directing a growing share of its $2.8 billion community benefit spending to address the social determinants of health.

By Rich Daly October 14, 2019

Oct. 13-18: Multiple national gatherings among key upcoming healthcare events

Key events include an HFMA webinar, national healthcare provider meetings and a House hearing on healthcare affordability.

By Rich Daly October 14, 2019

Don’t let infections hurt your bottom line

Finance leaders can ensure their organizations have the appropriate resources to combat healthcare-associated infections, said Susan Bleasdale, MD, of UI Health.

By Laura Ramos Hegwer October 13, 2019

Discharge Planning Final Rule Executive Summary

This document contains a high-level overview of CMS’s discharge planning final rule.

By HFMA October 11, 2019

HHS proposes 16 Stark, anti-kickback changes

HHS has proposed a range of rule changes to anti-fraud laws that providers say have blocked value-based payment arrangements.

By Rich Daly October 11, 2019

How to get a handle on Medicare bad debt

Medicare bad debt is a significant source of revenue leakage for hospitals and often is not adequately addressed.

By Jonathan Wiik October 10, 2019

Big drop in Medicaid enrollment drives 2018 increase in uninsured rate

In 2018, 1.9 million fewer people were covered by some type of health insurance, and they were most likely former Medicaid enrollees, according to new federal survey data.

By Rich Daly October 10, 2019

Analysis: Initial thoughts on the President’s recent Medicare executive order

A review and insight on several key points in the President’s Medicare executive order issued Oct. 3.

By Chad Mulvany, FHFMA October 9, 2019

Analysis: Walmart’s Sam’s Club unveils discount healthcare pilot program

A review of the Walmart Sam’s Club discount healthcare pilot program in three states and how the insight the company gleans about utilization and customer preferences will inform its health clinic concept pilot.

By Chad Mulvany, FHFMA October 8, 2019

Information imperatives for successful payer-provider collaboration

A roundtable of payer and provider leaders examines the importance of transparent communication, relationship-building and robust data sharing amid the transition to value-based care.

By HFMA October 8, 2019
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