Providers should prepare for a possible expansion of Medicare site-neutral policies
HFMA’s Chad Mulvany says if the CY2021 OPPS rule is finalized as proposed without significant modifications to CMS's MS-DRG weight-setting process, it heightens the need for hospitals to expand outpatient/ASC capacity and continue aggressive cost management.
Continued growth in employer-paid healthcare premiums may spur employers to find alternative solutions
HFMA's Chad Mulvany says large employers have signaled a possible end to their patience for traditional players to provide a traditional solution, and he reviews what solutions they could pursue instead.
Medicare readmissions reduction program penalizes hospitals inaccurately, study finds
The hospital readmissions reduction program incorrectly penalizes hundreds of hospitals, according to new research.
Latest HHS provider relief fund FAQs offer insight into what’s permissible under the Sept. 19 reporting requirements
HFMA's Chad Mulvany says due to HHS's whipsaw approach to the provider relief fund FAQs and guidance, any clarity to be derived from the Phase 3 application instructions and FAQs needs to be considered with a measure of caution.
Changes coming to bundled payments and Direct Contracting, CMMI chief says
Coming changes will affect both Medicare bundled payment programs and the looming Direct Contracting program, said the director of the Center for Medicare and Medicaid Innovation.
More Medicaid programs are planning inpatient hospital payment cuts
States are moving to cut their Medicaid inpatient hospital rates amid the pandemic and its more than 400,000 hospitalizations.
How to apply a value equation in setting compensation for specialty providers
An effective value-based compensation system for surgical specialists should not only account for the physician’s service, quality of care and financial performance, but also the extent to which the physician exhibits high standards of citizenship.
CMS to add COVID-19-related waivers to value-based payment models, Verma says
Medicare plans to add pandemic-era waivers to its value-based payment models as a way to incentivize provider participation.
340B cuts, inpatient-only elimination lead hospitals’ OPPS concerns
Proposed OPPS cuts for 340B hospitals and outpatient payment changes drew the most concerns from hospitals and advocates.
Rep. Suzan Delbene’s value-based payment legislation and Humana’s population health milestone in Medicare Advantage markets
Rich Daly interviews Rep. Suzan Delbene about the Value in Health Care Act, proposed legislation that would make a series of hospital-supported changes to value-based programs operated by Medicare. Andrew Renda of Humana talks about how the company improved Healthy Days in Medicare Advantage markets. In a sponsored segment, MedAssist Senior Vice President Nate Allen and Carilion Clinic's Vice President of Revenue Cycle Brett Tracy discuss Medicaid expansion in Virginia.