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University of Pittsburgh Medical Center (UPMC) has expanded its operations in Italy, buying a 50 percent stake in the 75-bed Salvator Mundi International Hospital in Rome and taking over clinical operations.

If the Graham-Cassidy proposal is passed by the Senate, most states would lose funding compared to what they be paid under the Affordable Care Act (ACA) in 2020, as the ACA’s insurance subsidies and Medicaid expansion funding would be turned into a fixed block grant. Over a 20-year period, healthcare funding to states will be reduced by $4 trillion, according to Avalere Health.

Insurance giant Anthem has announced it will acquire Florida Medicare Advantage plan HealthSun, which could add 40,000 members from the Miami metropolitan area to Anthem’s affiliated Medicare and Medicaid plans in the state.

The comment period for the proposed Medicare Physician Fee Schedule (PFS) has closed, with policy and payment updates drawing a typically mixed reaction from stakeholders within the industry.

One-sixth (17 percent) of physician practices responding to a Medical Group Management Association (MGMA) poll said they’re paying fees from 2 to 5 percent for receiving payments electronically—a practice the MGMA wants CMS to prohibit.

 

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.

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