Healthcare Reimbursement News

Characteristics of high-performing ACOs

High-performing accountable care organizations (ACOs) have five characteristics in common that help them achieve success with value-based payment contracting.

By HFMA May 19, 2019

Summary checklist for assessing readiness for value-based care

Healthcare finance leaders should use a checklist to assess their readiness to pursue value-based contracting.

By HFMA May 19, 2019

A timeline guide to developing an ACO/CIN

Healthcare organizations seeking to establish a an accountable care organization (ACO) or clinically integrated network (CIN) should allow for an eight-year, five-phase process

By HFMA May 19, 2019

Deceased Medicare beneficiary admissions: Accounting for the causes and impacts

Just over 3 percent of Medicare admissions end with the death of the patient. This finding is based on data from fiscal years 2015 through 2017 reported in the Medicare Provider Analysis and Review (MedPAR) file. As would be expected, the time and resources required to treat a beneficiary who is near death and ultimately…

By HFMA May 19, 2019

Provider nimbleness required for diverse value-based healthcare models

Many providers are in the throes of implementing strategies for value-based health care. But now they must adapt to an environment characterized by diverse value-based care models, new players, and more data to discern provider value. To weather the next decade, the key attribute providers will need is nimbleness—a challenge in an industry not known…

By Theresa Hush May 19, 2019

Analysis: Comparing commercial hospital rates to Medicare is inappropriate

RAND study says hospitals treating patients with private health insurance were paid 2.4-times the Medicare rates, but Chad Mulvany says Medicare is the wrong measuring stick.

By Chad Mulvany, FHFMA May 17, 2019

Medicare buy-in option beginning at 55 the most likely expansion route, says former CMS chief

If everything goes right for Democrats in the 2020 election, the most likely Medicare expansions are not the ones getting the headlines now, says a former Medicare administrator.

By Rich Daly May 16, 2019

Analysis: Making smarter decisions about where to recover after hospitalization | HTML

HFMA’s Chad Mulvany looks at why the transition from acute to post-acute is one of the greatest opportunities to improve clinical outcomes, the patient/caregiver experience of care and reduce the total cost of care for older adults.

By Chad Mulvany, FHFMA May 15, 2019

3 ways to remove the mystery from value-based payments

Daniel M. Grauman and Amanda Brown explain how analytic tools can assist a healthcare organization in identifying areas for improvement in value-based payments.

By Daniel M. Grauman, MBA, CPA/ABV May 15, 2019

Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs

CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.

By Chad Mulvany, FHFMA May 15, 2019
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