Course | Overview | Managed Care
This course provides an overview of the state of managed care today and discusses how and why it has evolved. It also identifies major initiatives that are currently affecting managed care and will continue to do so in the future, as the U....
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Course | Intermediate | Managed Care
This course discusses financial management, the central thread that interconnects the various elements of managed care. It explains various reimbursement methodologies commonly used in managed care and the underlying assumptions and risk ma...
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Course | Basic | Managed Care
This course discusses the healthcare delivery system in the U.S. and describes how various managed care models affect the quality and cost of care. It also describes the various relationships between providers and payers. Finally, it addres...
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Course | Overview | Managed Care
This course provides an overview of cost-accounting strategies related to managed care payment and contract issues. It also explains some of the modeling tools that providers can use to evaluate managed care contracts. It presents a broad o...
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Fact Sheet | Managed Care

HFMA Regulatory Overview: 2019 Medicare Advantage Final Rule

Fact Sheet | Managed Care

HFMA Regulatory Overview: 2019 Medicare Advantage Final Rule

This presentation provides an overview of CMS's 2019 Medicare Advantage program final rule, published in the April 16, 2018, Federal Register.

On April 6, 2018, the Centers for Medicare & Medicaid Services (CMS) put on display a final rule to revise the Medicare Advantage (MA) program (Part C) regulations and the Medicare prescription drug benefit program (Part D) regulations to implement certain provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. This presentation provides an overview of the major provisions of the final rule.

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Blog | Innovation and Disruption

Aetna rolls out a no-cost sharing primary care offering for members at CVS Minute Clinics and HealthHUBS

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Blog | Coronavirus

Pandemic increases pressures for rural hospitals struggling pre-COVID-19

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Comment Letter | Payment, Reimbursement, and Managed Care

Amicus Brief of The Healthcare Financial Management Association on Disclosure of 'Negotiated Charges'

HFMA presents its filed amicus brief on the American Hospital Association's appeal to overturn a Department of Health and Human Services rule requiring hospitals to disclose their privately negotiated rates with insurers.