Healthcare Reimbursement News

HFMA Regulatory Overview: 2019 Medicare Advantage Final Rule

This presentation provides an overview of CMS's 2019 Medicare Advantage program final rule, published in the April 16, 2018, Federal Register.

By HFMA April 26, 2018

Choosing the Right Path Forward for Value-Based Care

Thomas Schenk, MD, of BlueCross BlueShield of Western New York describes the health plan’s approach to supporting primary care physicians with a capitated payment system that accounts for local-market characteristics.

By Thomas Schenk April 25, 2018

The Study of Factors Influencing the Total Cost of Health Care

A study conducted by HFMA, Leavitt Partners, and McManis Consulting investigated factors driving the total cost of health care in the United States.

By HFMA April 25, 2018

What Is Driving Total Cost of Care?

A recent study identifies key factors that may be influencing total cost of care in the United States and provides recommendations for addressing those factors.

By James H. Landman, JD, PhD April 25, 2018

How Provider-Led ACOs Can Generate Long-Term Savings

Providers with concerns about the elusive success of ACOs should adopt some key strategies for implementation.

By Theresa Hush April 25, 2018

Creating APMs for Specialty Care: A Provider-Led Initiative for Delivering Value

The experiences of a large urology group practice can provide finance leaders with insight into key considerations involved with developing an advanced alternative payment model (APM) for a healthcare specialty area.

By Charles Saunders, MD April 25, 2018

MA Ruling May Signal Industry Readiness to Integrate SDH into Traditional Medical Care

In addressing social determinants of health and social services, a recent Medicare Advantage ruling by CMS may have taken the first steps toward providing more integrated and comprehensive care to the nation’s aging population.

By Gail R Wilensky, PhD April 25, 2018

Value: The Way Forward

Value-based payment won’t bend the cost curve unless healthcare organizations commit to fundamental change. Not everyone will come out whole. 

By Joseph J. Fifer, FHFMA, CPA April 25, 2018

The Current Outlook for Value-Based Care Under the Trump Administration

Value initiatives introduced by the Affordable Care Act have met with varied success. Under the Trump administration, the future of these initiatives is uncertain.

By Ken Perez April 25, 2018

Latest ACO Trends Identified

April 20—Although private accountable care organizations (ACOs) appear to be gaining ground, the Medicare versions are still leading—amid challenges.

By Rich Daly April 23, 2018
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