Payment Reimbursement and Managed Care

Analysis: How overcoming some hurdles can help providers manage PAC spend

HFMA’s Chad Mulvany discusses how the PAC-spending results of a recent study on older patients with joint replacements could easily apply to any number of common episodes of care experienced by Medicare beneficiaries.

By Chad Mulvany, FHFMA May 15, 2019

Analysis: What factors will come into play as stakeholders respond to a recent decision on Medicaid work rules

Key things to look for from all stakeholders even though the latest work requirement ruling only applies to the Kentucky and Arkansas cases.

By Chad Mulvany, FHFMA May 15, 2019

Analysis: CMS looks to partner with states to expand dual-eligible care models

CMS is encouraging states to test approaches to integrating dual-eligible patients’ care to improve outcomes and reduce costs for federal and state governments.

By Chad Mulvany, FHFMA May 15, 2019

Analysis: FY20 inpatient payment rule proposes changes to DSH, wage index

Chad Mulvany offers insight on some of the recent proposed changes to hospital Medicare IPPS payments. Issues discussed include the wage index, new technology add-on payments and FY20 UC DSH Factor 3.

By Chad Mulvany, FHFMA May 14, 2019

Analysis: Another year closer to depleting the Part A Trust Fund

With the predicted depletion of Medicare’s hospital insurance fund, and Congress unlikely to increase taxes for working people or hike costs for beneficiates, what should healthcare finance leaders expect?

By Chad Mulvany, FHFMA May 14, 2019

Analysis: Treasury projects Congress needs to raise the debt ceiling by late summer

Legislation to raise the debt ceiling is one of a limited number of “must pass” bills that healthcare policy changes can “ride on.”

By Chad Mulvany, FHFMA May 14, 2019

Ask the Experts: Provider Level Adjustments

Is there a best practice for handling provider level adjustments (PLBs) in electronic health record (EHR) systems?

By HFMA May 14, 2019

Ask the Experts: Cost per day

Where can we find benchmarking data across other skilled nursing facilities related to costs per day for patient care?

By HFMA May 14, 2019

Improving PHI Disclosure Efficiency in the Business Office

With pressure on providers to prove medical necessity and validate code assignments, business office staff must provide more patient information, such as medical records, putting greater demands on their time. Yale New Haven Health addressed this problem by implementing a centralized protected health information (PHI) disclosure management system.

By Kim Charland, BA, RHIT, CCS May 14, 2019

4 strategies for improved Medicare Advantage plan performance

Positive operating margins in the Medicare Advantage segment require a shift toward more effectively managing Medicare populations by recognizing their unique needs and characteristics.

By Tej Shah May 14, 2019
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