Healthcare Reimbursement News

Will New ACO Findings Save Upside-Only Models?

Sept. 11—A new analysis joins other research in reaching new conclusions about the extent of savings that accountable care organizations (ACOs)—especially upside-only models—provide Medicare. It’s a data battle that could determine whether many ACOs continue.

By Rich Daly September 12, 2018

Health System Demonstrates Meaningful Price Transparency Is Possible

Baptist Memorial Health Care’s online Expense Navigator allows patients to estimate out-of-pocket expenses according to their insurance status and check their eligibility for financial assistance.

By Lola Butcher September 11, 2018

PTAC Recommends New Models Amid HHS Promises

Sept. 10—Amid Medicare promises to soon introduce new physician-focused payment models, its leading advisory panel recently approved new models for consideration.

By Rich Daly September 11, 2018

HFMA Comments on the CY 2019 Physician Fee Schedule Proposed Rule

HFMA submits comments to CMS on the CY 2019 Medicare Physician Fee Schedule Proposed Rule, published in the July 27, 2018, Federal Register.

By HFMA September 10, 2018

Sept. 10-14: Unified Post-Acute Payment System Emerging

Sept. 6—As post-acute care leaders gather outside Washington, D.C., for a conference next week, a major payment overhaul is coming together.

By Rich Daly September 7, 2018

Medicaid Plans, Hospitals Clash over Proposed Kids Model

Sept. 5—Medicaid insurance companies and hospitals squared off in Congress this week over legislation to expand children’s medical homes nationally.

By Rich Daly September 6, 2018

MSSP ACOs Save $314 Million, As Changes Loom

Aug. 31—Medicare’s main group of accountable care organizations (ACOs) delivered big 2017 savings. Will that affect the program’s fate?

By Rich Daly September 4, 2018

Sept. 3-6: Deadline Coming for Latest CMMI Model, With More Options Ahead

Aug. 30—Even as physicians ponder joining a new Medicare Advantage (MA) payment model before next week’s deadline, they should expect more options in the coming months, according to the leader responsible for generating such arrangements.

By Rich Daly August 31, 2018

Not-for-Profit Hospitals Hit All-Time-Low Operating Margins: Moody’s

Aug. 29—Operating margins for not-for-profit hospitals fell to 1.6 percent in FY17, the lowest level one rating agency has ever found in its tracking.

By Rich Daly August 30, 2018

5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission

Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.

By HFMA August 29, 2018
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