Payment Reimbursement and Managed Care

Using Audits to Improve Compliance, Cut Future Audit Risk

Several steps can help hospitals and health systems leverage audits and their results to increase compliance and reduce financial risks from future audits.

Dawn Crump May 12, 2016

Making ACO Participation Pay Off

Delaware Valley ACO’s emphasis on improving care while lowering costs has proven effective, demonstrated by an increase in members from 5,000 to 200,000 in three years.

Chris Anderson May 10, 2016

HFMA Comments on CMS’s Part B Drug Payment Model Proposed Rule

This document contains HFMA's comments to CMS on the proposed changes to Medicare’s reimbursement methodology for separately payable Part B drugs.

HFMA May 9, 2016

Proposed Rule: Medicare Inpatient Hospital Operating and Capital Payment for Fiscal Year 2017

This document summarizes proposed payment rate updates to hospitals under the inpatient prospective payment system for fiscal year 2017.

HFMA May 5, 2016

Executive Summary: CMS 2017 IPPS Proposed Rule

This document provides an overview of the key financial and operating impacts of the FY17 IPPS proposed rule.

HFMA May 5, 2016

Summary of CMS’s Comprehensive Primary Care Plus (CPC+) Model

This document summarizes important details of CMS's Comprehensive Primary Care Plus (CPC+) model.

HFMA April 29, 2016

How Minnesota Safety Net Providers Found Success in a Medicaid Alternative Payment Model

A combination of preparation; using data to stratify patients by risk category; and integrating primary care, behavioral health, and social services is helping Minnesota safety net providers succeed in a Medicaid accountable care initiative.

Andis Robeznieks April 7, 2016

Ask the Expert: Payers Linking Cancellations of Separate Contracts

How can providers respond when payers threaten to terminate a Medicare Advantage contract if the provider terminates their separate commercial contract?

HFMA April 7, 2016

HFMA Comments on CMS’s Proposed Changes to the Medicare Shared Savings Program

HFMA submitted a comment letter to CMS on the proposed changes to the Medicare Shared Savings Program (MSSP) benchmarking and trending methodologies published in the February 3, 2016, Federal Register.

HFMA March 30, 2016

Medicare Overpayments Final Rule Fact Sheet

This fact sheet summarizes the final rule published by CMS requiring providers and suppliers receiving funds under the Medicare program to report and return overpayments. 

HFMA March 22, 2016
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