Payment Reimbursement and Managed Care

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

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.  

HFMA June 22, 2015

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

HFMA June 15, 2015

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

HFMA June 15, 2015

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

HFMA June 15, 2015

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.

HFMA June 5, 2015

HFMA Comments on CMS Bundled Payments for Care Improvement (BPCI) Initiative

HFMA proactively comments on issues related to CMS’s BPCI initiative to provide recommendations to address design issues with the episodes and other operational and administrative barriers.

HFMA May 22, 2015

HFMA Executive Survey: Value-Based Payment Readiness

HFMA Executive Survey: Value-Based Payment Readiness explores ways hospitals are readying their value-driving capabilities and determining ROI of efforts in an environment where incentives increasingly are focused on improving quality and reducing costs of care delivery for patient populations.

HFMA May 18, 2015
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