Payment Reimbursement and Managed Care

Negotiating Maternity Care Bundles

UTHealth’s maternity bundled payment pilot encountered two challenges: developing fair and consistent quality measures and defining what services would be part of the bundle.

Lola Butcher January 17, 2017

Message to Providers: Expect More Pricing Scrutiny

Healthcare finance leaders should review their organizations’ cost structure to ensure that their healthcare spending consistently adds value to patient care.

Jeff Helton,  PHD, FHFMA, CMA, CFE January 10, 2017

Sidebar: Small Physician Practices and the Merit-based Incentive Payment System (MIPS)

An example of financial modeling for a small physician practice is provided to illustrate possible effects of MACRA’s Merit-Based Payment System on such a practice.

John Harris, MBA January 9, 2017

Analyzing Where to Invest for Success Under MACRA’s New Quality Payment Program

Financial modeling can help providers determine their best option among payment models available through CMS’s new Quality Payment Program.

John Harris, MBA January 9, 2017

Prepping for Maternity Care Bundles

Many healthcare leaders think episode of care payments make sense for maternity and newborn care, but few know how to make them work. Those at the forefront of this payment innovation share what they have learned.

Lola Butcher January 9, 2017

MACRA Timeline: MIPS and Advanced APM Reporting Requirements for Payment Year 2019

This useful tool displays a MACRA final rule timeline of Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (Advanced APM) reporting requirements for payment year 2019.

HFMA January 9, 2017

The Challenge of Treating Addiction in America

HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, talks about the need for healthcare stakeholders to face the challenge of treating addiction in America.

HFMA January 3, 2017

Medicare’s Quality Initiatives Present New Management Challenges

Value-based purchasing and reduction of readmissions and hospital-acquired conditions are coming into focus for hospitals thanks to Medicare initiatives.

Paul Shoemaker December 19, 2016

Outlook for Healthcare Policy: Uncertain

Previous Republican initiatives to replace the ACA are being used to guide expectations about what a replacement measure would entail. 

Rich Daly December 19, 2016

The ACA—and Other Healthcare Issues Confronting a New Congress

Republicans have promised to repeal the Affordable Care Act when Congress convenes in 2017, but they have other healthcare considerations to address, as well. 

Gail R Wilensky, PhD December 19, 2016
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