Bridging the gap: Integrating value-based care into revenue cycle management
The idea of value-based care (VBC) has existed for decades but only gained momentum since the 2017 implementation of the Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP). VBC incentivizes providers for quality outcomes, unlike fee-for-service models that reimburse providers for each service performed. The ultimate goal of VBC is to improve…
Annual report on Medicare financing could reduce the immediate impetus to address longstanding issues
New data on the state of Medicare funding show short-term improvement while keeping the stakes high for ensuing decades. The annual report from Medicare’s trustees shows the Hospital Insurance Trust Fund (i.e., Medicare Part A) has enough money to keep beneficiaries covered and providers paid through 2036. That’s an increase of five years from the…
Congressional hearings on the Change Healthcare cyberattack bring attention to providers’ continuing predicament
Two congressional hearings involving the CEO of UnitedHealth Group offered few concrete solutions to the issues surrounding the Change Healthcare cyberattack but did highlight the ongoing pressures facing healthcare stakeholders. Andrew Witty, the CEO, was questioned May 1 by the Senate Finance Committee in the morning and a House subcommittee in the afternoon. For providers…
Seeking to improve healthcare for Medicaid beneficiaries, CMS issues a flurry of regulations
CMS over the last month published a trio of final rules intended to make the Medicaid program work better for beneficiaries, with implications for healthcare providers. The three rules address eligibility and enrollment, access and Medicaid managed care. Streamlining eligibility and enrollment The first rule addresses administrative barriers in an effort to simplify enrollment processes…
Navigating toward successful contract negotiations with health plans
A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.
Shawn Stack: The value of revisiting policies and processes for financial assistance
The charity care processes adopted by healthcare providers have attracted criticism in media stories focusing on the high cost of care. On a recent episode of HFMA’s “Voices in Healthcare Finance” podcast, HFMA Policy Director Shawn Stack discussed the value of revisiting financial assistance policies and processes. Below is an excerpt from the interview. Erika…
Reimagining charity care: How Monument Health puts patients first with an innovative financial assistance program
Depak Manmohan Goyal, MD, MBBS, MBA, executive director for revenue cycle and supply chain at Monument Health, remembers the case of a 40-year-old patient with late-stage cancer who sought care at the Rapid City, S.D., health system a few years ago before succumbing to her disease. An earlier and unrelated care episode ideally would have…
Healthcare Blame Game: New York Times medical debt piece dubbed ‘laziest story of the year,’ plus revisiting charity care policies
Brad examines a New York Times article by investigative reporter Sarah Kliff about a recent study of patients whose debt was eliminated by RIP Medical Debt. Researchers say the results surprised them.
It’s time to revisit your charity care policy
The cover story in the May issue of hfm focuses on a South Dakota health system that developed a new process to identify charity care patients. In this episode, HFMA Policy Director Shawn Stack discusses why good financial assistance policies and process are essential to patient care.
Three Questions to Ask your RCM Vendor Right Now
All RCM vendors say they take tech, talent, and problem-solving seriously. But do they? Download the white paper to consider some hard-hitting questions.