Ask the Experts: Contract performance
My organization recently transitioned to its first Ambulatory Payment Classifications (APC)/DRG-based contract with a commercial plan. We are struggling with determining how to monitor the contract’s performance and, in particular, with the primary focus on the APC payment. Are there recommended key performance indicators (KPIs) used to track this performance? Answer: It is likely that your organization…
Analysis: Movement seen on overdue Medicare Discharge Planning Rule
The Medicare Discharge Planning Rule, which was sent to the Office of Management and Budget last week, would require hospitals to provide patients with data to help guide their selection of a post-acute care provider.
Analysis: 4 significant findings from the recent AMGA Physician Risk Survey
HFMA’s Chad Mulvany discusses four findings from the latest AMGA Physician Risk Survey about the transition to alternative payment models and risk.
How to refine medical record sharing to mitigate risk and improve productivity
Careful review of medical record sharing costs and responsibilities stated in managed care contracts can reduce providers' expenses and productivity burden during payer reviews and audits.
Analysis: Comparing commercial hospital rates to Medicare is inappropriate
RAND study says hospitals treating patients with private health insurance were paid 2.4-times the Medicare rates, but Chad Mulvany says Medicare is the wrong measuring stick.
Analysis: UnitedHealthcare expands MA bundled payment plan offerings for 2020
HFMA’s Chad Mulvany says UnitedHealthcare’s move to expand its bundled payment offerings to providers in its Medicare Advantage plans in more than 30 states is a step in the right direction in support of providers’ efforts to transition to value-based payment models.
Analysis: Making smarter decisions about where to recover after hospitalization | HTML
HFMA’s Chad Mulvany looks at why the transition from acute to post-acute is one of the greatest opportunities to improve clinical outcomes, the patient/caregiver experience of care and reduce the total cost of care for older adults.
3 ways to remove the mystery from value-based payments
Daniel M. Grauman and Amanda Brown explain how analytic tools can assist a healthcare organization in identifying areas for improvement in value-based payments.
Policy changes needed to prevent hospital-based Medicare ACOs from being disadvantaged by high-cost patients switching from physician-led ACOs
CMS needs to implement changes to Medicare’s ACO models that hold hospital-led ACOs harmless when high-cost beneficiaries switch from physician-led ACOs.
‘Medicare for All’: Do the numbers
Healthcare leaders can foster a productive debate about “Medicare for All” by driving analyses based on data such as cost projections, writes HFMA President and CEO Joseph J. Fifer.