Reimbursement

Q&A: ACO Executive Expects Impacts from New Rules

Jan. 7—HFMA recently talked with the leader of one of the largest accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) about impacts she and other ACO leaders expect from the recently issued 2019 final rules for the program. Early industry reaction to the changes was mixed.

By Rich Daly January 8, 2019

Medicare Shared Savings Program 2019 Final Rule Summary

This document provides a comprehensive summary of December 2018 Medicare Shared Savings Program final rule, published by CMS.

By HFMA January 7, 2019

Jan. 7-11: Providers Mull ACO Regulatory Changes Ahead of Deadlines

Jan. 3—An overhaul of Medicare’s main accountable care organization (ACO) program was finalized in mid-December, and many providers looking to join or continue participating will be required to begin the process this month.

By Rich Daly January 4, 2019

Using Ambulatory Pricing Strategically to Protect and Grow Market Share

An increasing regulatory focus on price transparency also is an impetus for hospitals and health systems to pursue ambulatory care pricing strategies aimed at growing market share.

By Craig Allan Ahrens, MHA, MBA January 3, 2019

Medicare Shared Savings Program 2019 Final Rule: HFMA Executive Summary

This document briefly highlights noteworthy details of the 2019 Medicare Shared Savings Program final rule, published by CMS.

By HFMA January 3, 2019

Judge Rejects 2018 Cut to Medicare 340B Payments

Jan. 2—A federal judge recently ruled against a year-old 30 percent cut to Medicare payments for 340B drugs. But the ruling’s implementation—including the effect on 2019 payment—remains to be decided.

By Rich Daly January 3, 2019

Price Transparency: The View from Washington

HFMA President and CEO Joe Fifer discusses implications of a new federal report that addresses price transparency.

By Joseph J. Fifer, FHFMA, CPA December 26, 2018

Medicare’s Move Toward Site-Neutral Payment

A payment change in the OPPS final rule that aims to align payments made for services delivered in off-campus hospital outpatient departments with those made for services delivered in physician offices has raised considerable controversy.

By Gail R Wilensky, PhD December 26, 2018

Creating PSAs That Promote a Meaningful Hospital-Physician Bond

Professional services agreements between hospitals and physicians should be structured to create integrated, binding relationships that support value-based strategies and creation of a high-performing provider networks.

By John Fink December 26, 2018

Aligning Value-Based Contracts for Better Performance

A roundtable of senior financial leaders that offers strategies for evaluating, operationalizing, and aligning value-based contracts and care delivery work streams.

By HFMA December 21, 2018
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