Survey Shows Lack of Knowledge About MACRA

About half of hospital-based physicians said they were not knowledgeable about the Medicare physician pay overhaul (Medicare Access and CHIP Reauthorization Act of 2015—MACRA) that began earlier this year, according to a recent survey by KPMG and the American Medical Association. This represents a larger share compared with physicians in other settings.   The survey […]

HFMA: Preparing for New Bundled Payments Part 2

Last week we covered the first four elements for structuring cardiac payment bundles. These included establishing clear and achievable goals, focusing on inpatient costs and reducing care variations, being guided by data and focusing on medication management and compliance.   The remaining three elements are:   Reorganize to manage post-acute spending. Effective cost management requires a […]

HFMA: Preparing for Cardiac Bundled Payments Part 1

Approximately 2,440 hospitals will participate in the bundled payment program for cardiac care beginning in January 2018. Health systems around the country have identified essential steps for structuring cardiac bundle programs to optimize performance, according to a recent report from the Healthcare Financial Management Association.   Of the 2,440 hospitals that will participate, 1,120 in […]

Moody’s: NFP Hospitals Should Focus on Risk Management

The ability to implement effective strategies to minimize risk will become increasingly important in determining not-for-profit and public hospitals’ credit strength in the changing landscape. These hospitals are focused on risk management to avoid pitfalls and capitalize on new opportunities in anticipation of momentous changes, not the least of which is the fate of the […]

AHCA Medicaid Rollback Concerns Provider-Sponsored Plans

Under the House’s updated version of the American Health Care Act (AHCA), provider-sponsored plans expect decreased federal funding resulting in many of the people they cover becoming uninsured, and also hospital closures.   For example, one CEO of a provider-sponsored plan said recently at a not-for-profit healthcare investor conference, “The AHCA scares the hell out […]

Some Providers Tackle Food Insecurity as Part of Population Health Management

Economists estimate that two-thirds of all the cost of health care relates to what are called social determinants of health—those factors outside the acute care setting that affect health and cost. These factors include everything from exercise and healthy diet, healthy weight, to avoiding substance abuse or other self-destructive behaviors, to ensuring that people have […]

Experts Expect Senate to Significantly Change AHCA

On May 4 the House of Representatives passed a new version of the American Health Care Act (AHC) that made deep cuts to both Medicaid funding and marketplace subsidies. It now moves to the Senate, where experts predict it will undergo substantial changes.   Hospital groups opposed the newer version of the bill primarily because […]

Some Experts Predict Extension of MACRA Flexibility through 2018

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) determines only Medicare Part B payment, but hospitals and health systems will be affected through their employed and affiliated physicians. So those organizations are working to help their physicians succeed under the payment system, which will mean moving as quickly as possible to advanced alternative […]

Bundled Payments: Mandatory, Voluntary or Gone Altogether?

Policy experts recently weighed in on the future of the bundled payment program. Uncertainty has been the byword since the current administration delayed the start of the latest mandatory bundled payment program. Some have speculated that such models are “on their way out.” There is no consensus among experts.   A review of the background: […]