Payment Reimbursement and Managed Care

10 Critical Medicaid Trends to Watch

It is important for hospitals and health systems to forecast the impact of proposed healthcare legislation on Medicaid payments, eligibility teams, and patients.

Marie Hinds June 29, 2017

Part B Drugs Revisited—Yet Again

Payment and pricing for Medicare Part B drugs are subjects of much discussion again following the decision by CMS to withdraw its planned pilot projects for these drugs.

Gail R Wilensky, PhD June 20, 2017

How Providers Should Prepare for New Bundled Payments

Optimal preparation for new mandatory bundled payment models begins with establishing clear and achievable goals, focusing on inpatient costs and care variation, and reorganizing to manage post-acute spending.

Lisa Zamosky June 13, 2017

Preparing for MACRA Success

Christopher Stanley provides pointers for healthcare organizations preparing for the merit-based incentive program. 

Christopher Stanley June 9, 2017

HFMA Comments on CMS’s FY18 IPPS Proposed Rule

HFMA submitted comments to the CMS on the FY18 IPPS proposed rule published in the April 28, 2017, Federal Register.

HFMA June 8, 2017

Value-Based Care: Past, Present, and Future

Nick Vennaro delivers a retrospective on value-based care with an eye toward the future.

Nick Vennaro June 5, 2017

Ensuring Proper Payments for Substance Abuse Services

Substance abuse treatment providers can maximize payments through contract negotiations and eligibility verification and precertification processes.

Divya Annasingh June 5, 2017

Linking Professional Fee and Facility Fee Data to Get the Big Picture

Matching patient and encounter data helped one Vermont hospital overcome the challenges of working with two different billing systems for its facility and physicians.

Laura Ramos Hegwer June 5, 2017

Why Direct Primary Care Works for Me

Primary care physician Jeffrey Gold, MD, describes why direct primary care is rewarding for him and his patients.

Jeffrey Gold June 2, 2017

UAB’s Patient Navigation Program Saves $19 Million Annually

UAB Health System used a novel care model to reduce hospitalizations, emergency department visits, and intensive care stays for patients with complex cancers.

Laura Ramos Hegwer June 1, 2017
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