Former CMS Leaders: ACO Changes Are Coming
May 11—Medicare accountable care organizations (ACOs) are likely to face an imminent overhaul, according to former leaders of the program.
Competing with Freestanding Outpatient Centers—Where to Focus on Pricing
Price reductions should be included in pricing strategies to help hospitals better compete with these free-standing centers.
May 14-18: Senate Holds 340B Hearing Amid Surge in Activity
May 10—Congress will once again examine the 340B discount drug program next week amid several judicial and regulatory developments related to the program.
Avoid ED Claim Challenges by Developing CDI Teams
UnitedHealthcare’s new policy of auditing certain emergency department claims should prompt hospitals to seek the expertise of clinical documentation improvement teams in outpatient claim processing.
Ask the Experts: Calculating Contract DRGs
What is a simple way to accurately determine my current base DRG rate?
PHI Disclosure Management in the Business Office: Two Options for Greater Efficiency
Don Hardwick describes ways healthcare organizations can improve the process of releasing medical records to insurers.
FY2019 Medicare Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule
This summary highlights key provisions of the FY2019 Medicare inpatient rehabilitation facility prospective payment system proposed rule, published by CMS.
Ask the Experts: Credit Balances
How do other Florida hospitals initiate and work credit balances?
Medicare Chief Targets Upside-Only ACOs
May 7—Medicare accountable care organizations that don’t accept downside risk are not producing results, says Seema Verma, administrator of the Centers for Medicare & Medicaid Services.
Ensuring a High-Performing Referral Network
To be able to ensure patients receive high-quality care under value-base payment arrangements, primary care physicians require well-developed specialty networks for patient referrals.