Payment Reimbursement and Managed Care

Contemplating the Potential Impact of the AHCA

Understanding legislation proposed to repeal and replace the Affordable Care Act (ACA) is important, given that a bill to repeal and replace the ACA seems inevitable.

Mark Polston, JD March 21, 2017

Maximizing Out-of-Network Payment for Patients with ACA Exchange Products

Hospitals should take steps to ensure the receive the full payment to which they are entitled for out-of-network patients enrolled in health plans purchased on the Affordable Care Act insurance exchange.

Jennifer Rudenick Ecklund March 21, 2017

Four Strategies to Maximize Adult Immunization Quality and Financial Benefits

Jill Powelson describes how healthcare organizations can maximize revenue opportunities for immunizations.

Jill Powelson March 10, 2017

Value-Based Payment—from a Different Perspective

Giesinger Health System has gained many advantages from offering its own, provider-sponsored health plan.

Kurt J. Wrobel, FSA, MAAA March 3, 2017

Assessing the Impact of Medicaid Expansion

Medicaid expansion reduced the amount of hospital charity care in participating states, while charity care remained almost unchanged in non-participating states during the same time period.

David Koepke February 28, 2017

Building a Value Model for Population Health Management

A data-driven “value model” can help healthcare organizations plan the scale and pace of investments into population health management in preparation for value-based contracting.

Daniel J. Marino February 21, 2017

Beyond the Medicare Annual Well Visit: Maximizing Revenue for Hospital-Owned Practices

Medicare-covered services may present a new source of revenue for hospital-owned physician practices.

Cathy Zito February 21, 2017

The Fate of Value-Based Care with an ACA Repeal

The move to value-based care may not go forward under Republicans’ plan to repeal and replace the Affordable Care Act.

Ken Perez February 21, 2017

Hospitals Face Challenges From Medicare Cost and Payment Trends

An analysis finds that Medicare payments for hospital admissions are declining even as hospitals’ cost per admission is rising, pointing to an increased need for aggressive cost containment efforts by hospitals.

HFMA February 21, 2017

Alternative Payment Models: The Courage to Lead

Healthcare finance leaders are finding the courage to move forward with value-based payment despite the uncertainties of a new administration in Washington, D.C.

Joseph J. Fifer, FHFMA, CPA February 21, 2017
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );