Payment Reimbursement and Managed Care

Summary of H.R. 2: The Medicare Access and CHIP Reauthorization Act of 2015

This document summarizes key provisions of the The Medicare Access and CHIP Reauthorization Act of 2015 pertaining to the sustainable growth rate formula and other health-related topics.

HFMA May 11, 2015

HFMA Comments on Medicare Short Stay Payment Policy

HFMA comments on issues related to Medicare’s current payment policy for short stays, the Recovery Audit Contractor (RAC) program, and the impact of both on Medicare beneficiaries.

HFMA April 20, 2015

HFMA Comments on Hospital Improvements for Payment Act of 2014 Discussion Draft

HFMA comments to the U.S. House Committee on Ways and Means on the challenges of the Medicare Recovery Audit Contractor program and other policies that have had negative unintended consequences.

HFMA March 11, 2015

Improving Price Transparency

Access HFMA resources for improving price transparency.

HFMA March 11, 2015

CY15 Medicare Physician Fee Schedule Final Rule Fact Sheet

This document highlights important payment updates to physicians under the CY15 Medicare Physician Fee Schedule (PFS) final rule. 

HFMA February 19, 2015

NY Rural Providers Turn Medical Homes into an ACO

What makes this medical home project different from many others around the country is that it is an all-payer pilot. After lengthy negotiations between providers and payers, the health plans agreed to pay the medical homes $7 per member per month to care for some 100,000 patients during the first year.

Laura Ramos Hegwer February 12, 2015

HFMA Comments on the Proposed Rule on the Medicare Shared Savings Program

HFMA commended CMS for its efforts to modify the Medicare Shared Savings Program (MSSP) to ensure its sustainability. However, HFMA had specific recommendations for improvement.

HFMA February 11, 2015

Determining Your Options: Educating Your Board

It is essential to keep your organization's board of directors up to date on your organization's current situation, capabilities and needs, and potential options for acquisition or affiliation. As you narrow in on the most viable options and partners for your organization, the PowerPoint template tools below outline key elements of your proposed course of action that should be shared with the board. Options are provided for proposals involving both less than fully integrated and fully integrated acquisition and affiliation models. Tool: Educating Your Board: Less than Fully Integrated Models Tool: Educating Your Board: Fully Integrated Models Go to Next Page                              Home

HFMA February 10, 2015

Medicare Shared Savings Program Proposed Rule Fact Sheet

This fact sheet summarizes proposed changes by CMS that would update policies governing the Medicare Shared Savings Program.

HFMA February 6, 2015

Price Transparency for Health Plans

Because health plans will in most instances have the most accurate data on prices for their members, HFMA’s Price Transparency Task Force recommends that health plans serve as the principal source of price information for their members.  Many health plans have already developed or are in the process of developing web-based or telephonic transparency tools for their members. There are also a growing number of independent vendors that use data from health plans and/or employers in web-based tools and telephonic products to inform employees about price.    

HFMA January 26, 2015
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