Healthcare Reimbursement

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

How hospitals can create cost advantage where product differentiation is not present

Cost advantage can be achieved in two ways: Identifying whether efficient levels of cost exist and benchmarking.

By William O. Cleverley, PhD July 14, 2019

‘Medicare for All’ leader laments Medicare problems

A leading congressional advocate of “Medicare for All” this week excoriated Medicare for the billing problems she dealt with during her late husband’s last years of declining health. But she insists such headaches would not follow expansion of the program to all Americans.

By Rich Daly July 12, 2019

FY 2020 IPPS Proposed Rule Summary

Centers for Medicare & Medicaid Services released its proposed rule describing federal FY2020 policies and rates for Medicare’s prospective payment systems for acute care inpatient hospitals and the long-term care hospital prospective payment system.

By HFMA July 12, 2019

July 14-19: See what events are coming in healthcare

Stay ahead of healthcare news and developments with this listing of hearings, conferences, webinars, public forums and deadlines for the week of July 14.

By Rich Daly July 12, 2019

Rural-state hospitals hail changes to Medicare wage index

Rural-state hospitals strongly back a proposed Medicare area wage index (AWI) change, but national hospital advocates are warning against it.

By Rich Daly July 10, 2019

Is healthcare’s focus shifting from value to pricing?

Federal policy advisers see a shift from value-based payment to policies focused on cutting provider payments.

By Rich Daly July 10, 2019

July 8-12: See what events are coming in healthcare

Stay ahead of healthcare news and developments with this listing of hearings, conferences, webinars, public forums and deadlines for the week of July 8.

By Rich Daly July 8, 2019

CMMI chief: Administration’s value push will continue if ACA struck down

The senior government official in charge of creating value-based payment models said the Trump administration’s commitment to such models would continue even if the law authorizing his office is struck down in an ongoing court challenge.

By Rich Daly July 8, 2019

8 KPIs for measuring Medicaid eligibility and advocacy

A regular KPI review process will allow revenue cycle leaders to identify problems and develop a plan for remediation.

By Marie Hinds July 7, 2019

How hospitals saved $1,000 per case in a mandatory bundle

Several hospital approaches were key to obtaining savings of nearly $1,000 per episode in Medicare’s first mandatory bundled payment model.

By Rich Daly July 3, 2019
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