October 2018

Cover Story

How To | Contracting

A Blueprint for Building a ‘Risk Ready’ Healthcare Organization

The cornerstone capabilities healthcare providers require for success under risk contracts are contract modeling and negotiation, care management and coordination, analytics and technology, and relationships and alignment.

Web Exclusives

How To | Value-Based Payment

Where Providers Are Finding Value-Based Profit

Healthcare provider organizations that are seeking ways to successfully accomplish the shift from fee-for-service to value-based payment can gain insight from the experiences of provider organizations that are industry leaders in this transition.

Case Study | Staff Development

AI Meets Health Care’s Turnover Problem

One health system found that artificial intelligence (AI) can provide an effective means to ensure the right nurses are hired for the right roles, which helps it meet strategic goals on quality, satisfaction, and costs.

How To | Benchmarking and Forecasting

Transitioning to a New Medicare-Based Benchmarking Paradigm for Commercial Payment

As commercial health plans adopt a case-rate approach to payment based on Medicare’s MS-DRGs, modifications are needed to account for how health plans’ populations differ from the Medicare population.

Trend | Healthcare Business Trends

The Conscience of the Generic Drug Market

Created to address the high costs and shortages of generic medications, the not-for-profit generic drug manufacturer Civica Rx aims to be a societal asset by providing patients across the nation with affordable access to the medications they need.

Features

How To | Value-Based Payment

7 Considerations in the Financial Modeling of Value-Based Payment Arrangements

In preparing for the impact of changing to value-based payment, hospitals must be able to predict the gain or loss from related incentives, penalties, volume changes, and other factors. Seven considerations provide a guide to successfully managing the shift. 

How To | Bundled Payment

Preparing for BPCI-A: Avoiding the Common Mistakes Providers Make when Implementing New Payment Models

The primary goal for healthcare providers participating in Bundled Payments for Care Improvement Advanced (BPCI-A) should be to master the competencies associated with becoming a high-value provider.

Case Study | Value-Based Payment

Lessons Learned from New York State’s Transition to Value

New York is a leader among U.S. states in promoting the healthcare industry’s transition to value-based payment, and healthcare providers nationwide can benefit from understanding the details of the state’s approach. 

Case Study | Bundled Payment

Getting Proactive About Bundles

Building on lessons learned from early bundle experiences, a midwestern health system is proactively designing its own bundles as it works with insurers and the state to craft bundles that better represent clinical and operational realities.

News | Consumerism

Creating a Consumer-Centric Healthcare Delivery System: A Report from HFMA’s 2018 Annual Conference

A cohort at HFMA’s Annual Conference examined various strategies for enhancing the patient financial experience.

Focus Area

Column | Healthcare Reform

Beyond the Rhetoric: Implications and Unintended Consequences of Tax Reform and Medicare Policy

Tax reform and changes in federal healthcare policy could have the unintended effect of exacerbating the challenges U.S. hospital face in contending with uncompensated care.

Columns

Trend | Healthcare Business Trends

The Ongoing Pursuit of Better Payment Models

HFMA will be your source for all things related to payment trends, as it may be one of the hottest topics in our industry. 

Column | Healthcare Reform

The Trump Administration’s Proposed Reorganization of the Federal Government: Implications for Health Care

President Trump is proposing significant reforms to government structure that may improve administrative efficiency but may at the same time gut what is left of the nation’s safety net.

Trend | Healthcare Business Trends

Understanding the System Bottom Lines for Market-Based Primary Care

The concept of primary care is being transformed by changes to its subsystems related to  demand, supply, organization, and linkages.

Column | Patient Financial Communications

It’s All Connected

Efforts to improve the patient financial experience should not be undertaken in isolation. HFMA President and CEO Joe Fifer explains why.

Supplements

How To | Revenue Cycle

Data Analytics and the Revenue Cycle

A research highlight that delves into key takeaways from a May 2018 HFMA member survey about the use of data analytics in the revenue cycle. 

How To | Technology

Strategies for Automating Accounts Payable

Tips-focused article about automating procurement and payables processes that shares benefits and offers real-world success strategies. 

Advertising

Trendsetter | Value-Based Payment

At the Tipping Point for Assuming More Risk

An in-depth look at how organizations can build capabilities to implement effective value-based payment contracts and care delivery models.