Reimbursement

HFMA Comments on the CY 2019 Physician Fee Schedule Proposed Rule

HFMA submits comments to CMS on the CY 2019 Medicare Physician Fee Schedule Proposed Rule, published in the July 27, 2018, Federal Register.

By HFMA September 10, 2018

Sept. 10-14: Unified Post-Acute Payment System Emerging

Sept. 6—As post-acute care leaders gather outside Washington, D.C., for a conference next week, a major payment overhaul is coming together.

By Rich Daly September 7, 2018

Medicaid Plans, Hospitals Clash over Proposed Kids Model

Sept. 5—Medicaid insurance companies and hospitals squared off in Congress this week over legislation to expand children’s medical homes nationally.

By Rich Daly September 6, 2018

MSSP ACOs Save $314 Million, As Changes Loom

Aug. 31—Medicare’s main group of accountable care organizations (ACOs) delivered big 2017 savings. Will that affect the program’s fate?

By Rich Daly September 4, 2018

Sept. 3-6: Deadline Coming for Latest CMMI Model, With More Options Ahead

Aug. 30—Even as physicians ponder joining a new Medicare Advantage (MA) payment model before next week’s deadline, they should expect more options in the coming months, according to the leader responsible for generating such arrangements.

By Rich Daly August 31, 2018

Not-for-Profit Hospitals Hit All-Time-Low Operating Margins: Moody’s

Aug. 29—Operating margins for not-for-profit hospitals fell to 1.6 percent in FY17, the lowest level one rating agency has ever found in its tracking.

By Rich Daly August 30, 2018

5 DRGs Are Primary Contributors to Rising Average Loss per Medicare Hospital Admission

Among Medicare admissions in 2015 to 2017, costs per admission rose more rapidly than did payments, and the impact of this trend on hospitals’ financials strongest with admissions associated with 5 DRGs.

By HFMA August 29, 2018

Administration Meets Challenge to Risk-Adjustment Payments, Counter to Critics’ Assumptions

Responding to a New Mexico district court’s ruling against the risk-adjustment program established by the Affordable Care Act, CMS initially put the program’s payments to collections and payment on hold, but then took steps to reinstate the program.

By Gail R. Wilensky August 29, 2018

4 Steps for Success in a Changing Payment Landscape

The experiences of oncology practices participating in CMMI’s Oncology Care Model offer insight on how physician practices can best adapt their revenue cycle for value-based payment models.

By Charles Saunders, MD August 29, 2018

Next Gen ACO Savings Could Bolster Medicare ACO Changes

Aug. 27—The most advanced Medicare accountable care organizations (ACOs) saved $100 million in their first year, according to a new report. And such savings could bolster Medicare’s proposed transition to greater risk for other ACOs, some industry watchers said.

By Rich Daly August 28, 2018
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