You are here

Finance

 

If the 5 percent bonus payment in the Advanced Alternative Payment Model (APMs) track was available in 2015, accountable care organizations (ACOs) would’ve earned additional net payments of $886 million if they had assumed downside risk under the Medicare Shared Savings Program (MSSP).

Most doctors saw a similar increase in compensation last year as they had in 2015, with an average raise of 2.9 percent across all specialties reported in the American Medical Group Association’s (AMGA) annual medical group compensation and productivity survey. Productivity, however, remained flat, and the move to value-based incentives in compensation continues to be slower than anticipated.

CMS has released its proposed rules for the 2018 Physician Fee Schedule (PFS), Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, with the biggest change being halving the Medicare reimbursement for off-campus services.

President Donald Trump had proposed a 16 percent cut across HHS in his budget blueprint for fiscal year 2018, but the Republican majority on the House Appropriations Committee added $14.5 billion over his request in its own budget proposal released on July 12.

Jason Considine, senior vice president of patient collections and engagement at Experian Health, argued at the Healthcare Financial Management Association (HFMA) conference in Orlando that providers should first rely on leveraging data and crafting flexible payment options before paying any contingency fees to collectors. He spoke with HealthExec about mistakes providers are making with their collection practices and what data they need to improve the process.

 

Recent Headlines

HFMA 2017: Experian’s Nicole Rogas says systems risk ‘financial distress’ if married to old RCM ways

An ever-changing world of reimbursement can be frustrating for those involved in revenue cycle management (RCM). Being too set in your ways to change, however, is one of the most common strategic mistakes seen by Nicole Rogas, MBA, senior vice president of sales at Experian Health.

HFMA 2017: Patientco’s Alan Nalle on how predictive modeling can improve patient billing

Predictive modeling has been shown to help providers assess patient risk for a variety of conditions—which is how the vast majority of hospitals and health systems have been utilizing it.

The hot topics of HFMA 2017

In a year with new payment tracks for Medicare, additional bumps in the road on the path to value-based care and—potentially—an overhaul of health insurance coverage coming through Congress, what are healthcare finance leaders going to be focused on at this year’s conference?

AHCA could lead to 725,000 fewer healthcare jobs

The Republican-sponsored American Health Care Act (AHCA) could “trigger an economic downturn in nearly every state,” according to a new report from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund, with the majority of the job losses coming from the healthcare industry.

AMA 2017: Outpatient services to drive profitable growth for health systems

Health systems looking for ways to grow profits should focus on sites of care and know what kind of insurance plans their patients may be utilizing, with much of the growth being seen in outpatient services.

10 costliest claims conditions account for $1.3B from 2013 to 2016

Sun Life has released its fifth annual “Sun Life Stop-Loss Research Report," outlining the top 10 catastrophic claims conditions. The report provides data from 53,000 claimants and $4.5 billion in stop-loss reimbursements to project changes over time in costs of medical conditions.

Med groups to CMS: Include Medicare Advantage patients under Advanced APMs

Ten healthcare industry groups, including the American Medical Association, have asked CMS to allow Medicare Advantage (MA) patients to count towards the threshold requirements to qualify as an Advanced Alternative Payment Model (APM).

New York public hospitals eliminating 476 positions

The largest public health system in the U.S., NYC Health + Hospitals, announced on June 2 it will lay off 396 managers and eliminate 80 currently unfilled positions as it faces a projected budget of $6 billion through 2020.

Insurers favor value-based contracts, but few are available

The majority of health plans responding to a Avalere Health survey said they have favorable attitudes towards value-based contracts, though smaller numbers of insurers are actually pursuing or have entered into those agreements.

EDs may charge 12.6 times Medicare prices—with higher markups than other departments

Emergency department services like suturing a wound or interpreting a CT scan may result in patients being charged up to 12.6 times more than what Medicare would pay, with minorities and uninsured patients the most likely to be hit by the markups.

Pages