HHS can continue using Worksheet S-10 to calculate uncompensated care payments after federal court ruling
A federal district court dealt hospitals a defeat in a case about uncompensated care payments, issuing a summary judgment in favor of the U.S. Department of Health and Human Services.
4 keys to sustaining financial viability in the shift to value
A leading ACO in Texas has found a way to thrive despite systemic factors that can discourage value-based initiatives.
OIG report suggests Medicare pays too much to cover capital costs for new hospitals
A new federal report indicates CMS pays excessively to cover capital expenditures during the first two years of a hospital’s existence.
How physicians, hospitals and health systems should prepare for the operational and financial impact of 2021 E/M code changes
In this Q&A, Craig Joseph, MD, chief medical officer for Nordic Consulting Partners, provides insight into why physicians, hospitals and health systems should pay attention to new E/M coding guideline changes are going into effect on January 1, 2021.
Research examines whether financial challenges facing hospitals with large Medicare populations lead indirectly to cost shifting
Harvard researchers found evidence to suggest that hospitals with large shares of Medicare patients are at greater risk of being acquired, which can skew the market structure and lead to higher commercial prices.
Evolving approach to federal value-based payment models will emphasize equity, affordability
Leaders with CMS and the Center for Medicare & Medicaid Innovation have published a rough blueprint of the future of value-based payment at the federal level.
FY22 rule for the Inpatient Prospective Payment System finalizes a payment increase and key policy updates
The base payment increase for hospital inpatient services in FY22 will be 2.5%, according to a final rule issued by CMS.
Study: In price negotiations with hospitals, self-insured employers lack leverage
The vast difference in market power between hospitals and employers leaves the latter group with little recourse in negotiations, according to a new study.
In 2022 OPPS rule, CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists
The 2022 proposed rule for the Outpatient Prospective Payment System would reverse 2021 policies that began to phase out the inpatient-only list of procedures and expand the covered-procedures list for ambulatory surgical centers.
CMS’s 2022 Medicare Physician Fee Schedule proposed rule: A look at telehealth provisions and overall payment rate changes
Clinicians will be able to seek payment for providing mental health visits to Medicare beneficiaries via audio-only telehealth, according to newly proposed regulations from CMS.