Payment Models

Moving a 340B covered entity’s pharmacy enterprise to an LLC may prove beneficial, but it requires a feasibility study

University of Utah Hospitals and Clinics (UUHC) in Salt Lake City performed research to assess the feasibility of moving its 340B covered-entity pharmacy enterprise to a Limited Liability Corporation (LLC), with a focus on risks that should be factored into the decision. Other organizations that are considering such a move could benefit from adopting UUHC’s assessment approach.

Nathan Hagen, PharmD, MS July 21, 2021

Newer payment models should be part of holistic transformation efforts, CMS deputy administrator says

Healthcare industry stakeholders can expect a new approach to how federal payment models are formulated, as a newly released rule for Medicare coverage of kidney care illustrates.

Nick Hut July 9, 2021

MedPAC report: Cost-based reimbursement isn’t an ideal way to sustain rural hospitals

An extensive healthcare policy report by the Medicare Payment and Advisory Commission includes a discussion about the drawbacks of cost-based Medicare reimbursement for rural hospitals.

Nick Hut June 16, 2021

Healthcare News of Note: Sg2 report says lower-acuity care to continue its migration outside of hospital walls

 Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Hospitals to continue to see loss of lower-acuity care, nursing shortage spurs health systems to offer sign-on bonuses and some newly passed state laws could put public health at risk.

Deborah Filipek June 10, 2021

Why fee-for-service can have a place in a reimagined healthcare system, but not as the primary mode of payment

Fee-for-service came under fire during a workshop in which prominent healthcare industry experts spoke of ways to achieve better integration of financing and care delivery.

Nick Hut June 9, 2021

Weeding out waste: Policy workshop examines how the healthcare industry can finance a better model

By reducing wasteful spending, the U.S. healthcare industry would have an easier time funding some of the changes needed to support whole-person health, industry experts said at a conference on how to optimize healthcare financing.

Nick Hut June 1, 2021

As the Senate Finance Committee considers telehealth expansion, payment approaches are a key talking point

A congressional hearing featured testimony about why fee-for-service is not a viable way to fund a Medicare telehealth expansion.

Nick Hut May 20, 2021

CMS is curtailing voluntary participation in the Comprehensive Care for Joint Replacement bundled payment model

Hospitals that participated in the Comprehensive Care for Joint Replacement model on a voluntary basis over the last three years will be excluded after Sept. 30.

Nick Hut May 3, 2021

Why the federal agency that oversees healthcare payment innovation is rethinking its approach

The director of the Center for Medicare & Medicaid Innovation is conducting a “strategic refresh” of the agency to consider how the healthcare industry’s transition to value can be improved.

Nick Hut April 25, 2021

CMMI announces Direct Contracting participants but cancels second round of applications

The Center for Medicare & Medicaid Innovation announced the 53 entities that have been accepted as participants in the new Global and Professional Direct Contracting model.

Nick Hut April 9, 2021
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