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.
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).
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).
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.
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 comments on the Senate Finance Committee Chairmen’s Audit & Appeal Bill
HFMA comments on the Senate Finance Committee Chairman's Mark of the AFFRIM Act to put forth solutions to the challenges faced by hospitals and beneficiaries from overlapping recovery audit programs.
Moving Forward: Case Studies
As part of its Value Project research, HFMA visits a number of healthcare organizations to learn firsthand how they are moving forward on the transition to value. The following three case studies are composites based on the organizations visited as
Determining the Process
Once an organization has identified its cost reconfiguration opportunities, it must put into place a process to ensure that those opportunities are realized and, once realized, maintained. Who should be involved? The overall
Assessing the Situation
As organizations position themselves for a value based care delivery and payment system, they must be alert both to opportunities for reducing cost structure and to the need to build the capabilities and make the investments needed to engage in
FY16 IPPS Proposed Rule Fact Sheet
The fact sheet provides a summary of CMS's proposed rule updating payment rates for FY16 under the Medicare IPPS for operating and capital-related costs of acute care hospitals.