Payment Reimbursement and Managed Care

FY18 Proposed Changes to the Long-Term Care Hospital (LTCH) Prospective Payment System

This document summarizes the FY18 payment rate updates under the long-term care hospital prospective payment system (LTCH PPS), published by CMS in the April 28, 2017, Federal Register.

HFMA May 18, 2017

Q&A: Exploring the Nuances of MACRA

Physician practices and other healthcare organizations should be aware of various nuances that will affect their performance in both the MIPS and advanced APM tracks of MACRA.

Nick Hut May 18, 2017

Gauging the Financial Impact of MIPS

The financial impacts of MIPS scores can amount to millions of dollars per organization and will significantly grow over the next several years.

Tom S. Lee May 16, 2017

Why Horizon BCBSNJ Likes Episode-of-Care Payments

Horizon Blue Cross Blue Shield of New Jersey’s episode-of-care program, believed to be the largest such program in the country, rewards physicians for successes but does not subject them to penalties. Horizon says that this arrangement creates better foundations for payer/provider relationships to move toward shared risk over time.

Lola Butcher May 16, 2017

Toward a Common Vision for Value Based Care Metrics

Reporting dozens of potentially conflicting metrics from government and commercial payers can be a burden on providers, who seek ways to streamline or prioritize the number of metrics.

Laura Ramos Hegwer May 15, 2017

Understanding the Current State of MACRA

Hospitals and their employed physicians should take certain actions now to avoid penalties and ensure proper payment under MACRA, as well look at future education and staffing needs.

Chris Stanley, MD, MBA May 12, 2017

Value-Based Care Looming

Tawnya Bosko explains why leaders who have plans to strengthen their bottom line will be better equipped to manage risk and plan for long-term sustainability in a value-based system. 

Tawnya Bosko May 11, 2017

FY18 IPPS Proposed Rule Summary

This document provides a comprehensive summary of the FY18 IPPS proposed rule, published by CMS.

HFMA May 11, 2017

Health Systems Brace for MACRA

Hospitals and health systems are working to help their physicians succeed under MACRA, which means moving quickly to advanced APMs.

Rich Daly May 11, 2017

What’s in Your Pricing Policy?

A recent survey reports that the majority of hospitals have formal or consistent methods for setting prices, but transparency is often missing.

HFMA May 11, 2017
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