Healthcare Reimbursement

Articles covering payer reimbursement, managed care, payment models, revenue optimization, and healthcare payment policy changes.

Election Special: As the votes are tallied, we look at what the possible outcomes mean for healthcare

As the world waits for the results of the presidential election and other key races, Rich Daly and Chad Mulvany discuss what could happen in the coming months. Also in this episode, Joe Fifer interviews 4sight Health CEO Dave Johnson about what's next for hospitals after COVID-19. This episode is sponsored by TRIMEDX.

By Erika Grotto December 29, 2020

Congress passes funding compromise with only $3 billion in provider aid

A final federal spending and coronavirus relief package includes big wins and losses for hospital finances.

By Rich Daly December 22, 2020

340B Program success depends on the quality of self-auditing

Healthcare organizations participating in the 340B Drug Pricing Program should self-audit of their compliance with the program to ensure its ongoing success and effectiveness.

By Brian Matney, CPA, CHFP December 22, 2020

The healthcare value imperative: All eyes on North Carolina’s move to value-based payment

Hospitals and health systems nationwide can benefit from the insights of North Carolina health system executive whose organizations are leading the way in the state’s transition to value-based payment.

By Eric C. Reese, PhD December 18, 2020

Medicare Advantage concepts come to Medicare fee-for-service with Geographic Direct Contracting Model

While the MA Stars Rating program is a bonus program where plans can earn additional revenue for achieving high scores, quality in the Geographic Direct Contracting program is treated more like a penalty, says HFMA's Chad Mulvany.

By Chad Mulvany, FHFMA December 17, 2020

Financial Sustainability Report: November 2020

The November 2020 Financial Sustainability Report, sponsored by Kaufman Hall, explores the long-term implications for hospitals and health systems of the deferral of elective procedures at the start of the COVID-19 pandemic, and it provides insights into healthcare organizations’ need for consumer-focused strategies. Other topics include 340B compliance and revenue cycle redesign after COVID-19.

By HFMA December 16, 2020

Amid some resistance by healthcare workers, COVID-19 vaccine delivery continues to roll out

Amid the early rollout of COVID-19 vaccines, provider organizations are urging reluctant clinicians and other employees to take the inoculation.

By Rich Daly December 16, 2020

Hospitals begin to receive first doses of COVID-19 vaccines

Hospitals and other providers that were prioritized in state COVID-19 vaccine distribution plans have begun to receive and administer their first doses.

By Rich Daly December 15, 2020

CMS waiver for hospital-at-home designed to address COVID-19-driven capacity issues | HFMA

While it’s been rumored that the Center for Medicare & Medicaid Innovation was working on a hospital-at-home model, this is a short-term waiver designed to address COVID-19-driven capacity issues, said HFMA’s Chad Mulvany.

By Chad Mulvany, FHFMA December 14, 2020

Patient visit restrictions bringing many new costs

Ongoing hospital visitor restrictions can have a range of adverse effects, potentially affecting clinical outcomes and increasing costs for health plans and providers in value-based payment models.

By Rich Daly December 11, 2020
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