Payment Reimbursement and Managed Care

HFMA Comments on CMS’s CY16 Physician Fee Schedule Proposed Rule

HFMA comments on the 2016 Medicare Program; revisions to payment policies (including advance care planning) under the physician fee schedule for CY 2016.

HFMA September 18, 2015

340B Drug Pricing Program Proposed Guidance Summary

This executive summary highlights important components of the Health Resources and Services Administration’s (HRSA) proposed 340B “Mega-Guidance.”

HFMA September 18, 2015

HFMA Comments on CMS’s CCJR Payment Model Proposed Rule

HFMA comments on CMS’s proposed rule for Comprehensive Care for Joint Replacement (CCJR) Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services.

HFMA September 17, 2015

HFMA Comments on CMS’ FY2016 Hospital OPPS Proposed Rule

HFMA highlights concerns and provides recommendations on key payment policy issues in the FY16 Medicare outpatient PPS proposed rule.

HFMA September 2, 2015

Comprehensive Care for Joint Replacement Payment Model Proposed Rule Fact Sheet

This fact sheet provides a summary of the new Comprehensive Care for Joint Replacement (CCJR) payment model proposed rule released by CMS.

HFMA August 25, 2015

How Accurate Mortality Risk Measurement Improves Quality and Value

Keeping risk-adjusted mortality rates low is an essential step when pursuing risk-based payment arrangements, says Brett Senor, MD.

Kathleen B. Vega August 24, 2015

CY16 OPPS Proposed Rule Fact Sheet

This document highlights the proposed prospective payment system updates to Medicare outpatient hospitals and ambulatory surgical centers for calendar year 2016 (CY16).

HFMA August 7, 2015

ACO Final Rule Fact Sheet

This document contains highlights of the final rule addressing changes to the Medicare Shared Savings Program, including provisions pertaining to Accountable Care Organizations (ACOs).

HFMA July 23, 2015

Discerning the Impact of Lesser-Than and Greater-Than Provisions in Payer Contracts

If hospitals do not take these payment provisions into account, a small price adjustment could result in a significant revenue hit, says William O. Cleverley.

Kathleen B. Vega July 20, 2015

HFMA Comment Letter: CMS’ FY2016 Hospital IPPS Proposed Rule

HFMA comments on the CMS analysis and discussion of the myriad Medicare hospital reimbursement decisions addressed in the 2016 IPPS Proposed Rule.

HFMA July 1, 2015
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