Healthcare Reimbursement News

Market disruption: How 4 healthcare leaders are dealing with it in their own organizations

This roundtable reviews disruptors and how some healthcare leaders deal with new entrants to the market, telehealth and the trend of care shifting to a nonhospital environment.

By HFMA November 4, 2021

Additional requirements are needed to make healthcare price transparency worthwhile, report states

Updates to price transparency regulations should address compliance and formatting and incorporate new data elements.

By Nick Hut November 4, 2021

Payment approaches to addressing health equity are seen in a new Medicare rule for kidney care

Updates to a Center for Medicare & Medicaid Innovation care model for end-stage renal disease include an equity-related bonus payment and associated changes to benchmarking.

By Nick Hut October 31, 2021

The impact of COVID-19 further shows the need to modify federal pay-for-performance models, hospital advocate says

Quality measures derived during the COVID-19 pandemic are not an accurate gauge of hospital performance in federal programs such as Value-Based Purchasing.

By Nick Hut October 29, 2021

The Provider Relief Fund distribution formula may have left some higher-need hospitals at a disadvantage, study finds

Critical access hospitals generally received lower allocations from a targeted distribution pool compared with hospitals that had a better asset mix.

By Nick Hut October 28, 2021

The Medicare area wage index likely needs a revamp, MedPAC members say

Wage index adjustments leave some hospitals at a disadvantage and are costly for the Medicare program, according to policy advisers.

By Nick Hut October 25, 2021

Addressing U.S. healthcare system challenges requires a focus on improving health, not just care

If we are to effectively address the huge cost challenges facing the U.S. health system, we must begin to better address the cost effectiveness of health, says Todd Nelson, HFMA’s director of professional practice and partner relationships. And it has to be through a collaborative process involving all stakeholders, he says, including not just hospitals and health systems, physicians and health plans but also patients and their communities, as well as society overall.

By Eric C. Reese, PhD October 22, 2021

Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage

The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.

By Nick Hut October 22, 2021

Research highlights ways to save more than $250 billion per year through healthcare administrative simplification

Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.

By Nick Hut October 22, 2021

Accountable care models will be almost universal for Medicare and Medicaid beneficiaries by 2030, CMS leaders say

A forthcoming revamp of federal value-based payment models will include features designed to encourage provider participation, CMS and CMMI leaders said.

By Nick Hut October 21, 2021
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