Healthcare Reimbursement News

Why Horizon BCBSNJ Likes Episode-of-Care Payments

Horizon Blue Cross Blue Shield of New Jersey’s episode-of-care program, believed to be the largest such program in the country, rewards physicians for successes but does not subject them to penalties. Horizon says that this arrangement creates better foundations for payer/provider relationships to move toward shared risk over time.

By Lola Butcher May 16, 2017

Toward a Common Vision for Value Based Care Metrics

Reporting dozens of potentially conflicting metrics from government and commercial payers can be a burden on providers, who seek ways to streamline or prioritize the number of metrics.

By Laura Ramos Hegwer May 15, 2017

Understanding the Current State of MACRA

Hospitals and their employed physicians should take certain actions now to avoid penalties and ensure proper payment under MACRA, as well look at future education and staffing needs.

By Chris Stanley, MD, MBA May 12, 2017

Value-Based Care Looming

Tawnya Bosko explains why leaders who have plans to strengthen their bottom line will be better equipped to manage risk and plan for long-term sustainability in a value-based system. 

By Tawnya Bosko May 11, 2017

FY18 IPPS Proposed Rule Summary

This document provides a comprehensive summary of the FY18 IPPS proposed rule, published by CMS.

By HFMA May 11, 2017

Health Systems Brace for MACRA

Hospitals and health systems are working to help their physicians succeed under MACRA, which means moving quickly to advanced APMs.

By Rich Daly May 11, 2017

What’s in Your Pricing Policy?

A recent survey reports that the majority of hospitals have formal or consistent methods for setting prices, but transparency is often missing.

By HFMA May 11, 2017

Improving Healthcare Quality: Four Proven Health Plan Strategies That Providers Should Adopt

Emad Rizk outlines lessons healthcare providers can learn from health plans’ approach to value.

By Emad Rizk May 10, 2017

CMS’s 2018 IPPS Proposed Rule and RFI: Signaling the Trump Administration’s Deregulation Agenda

Ken Perez describes the connection between the effort to repeal and replace the Affordable Care Act and a new proposed rule and request for information by CMS.

By Ken Perez May 8, 2017

Overview of the American Health Care Act

This slide deck summarizes the American Health Care Act as passed on May 4, 2017.

By HFMA May 5, 2017
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