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

Medicare Advantage plans get better than expected rate hike for 2018

Payments to insurers offering Medicare Advantage plans will increase by an average of 0.45 percent, according to the final rate notice issued by CMS, above the 0.25 percent bump in pay the agency had previously proposed.

CMS: Medicaid DSH payments will consider what Medicare, third-party pay

In a final rule issued on March 30, CMS clarified uncompensated care costs for Medicaid patients are limited by what a hospital received from other sources, such as commercial insurers, Medicare or the patients themselves.

ACHE 2017: Creating a provider-sponsored health plan means understanding your market

The lines are blurring between healthcare providers and payors as more providers are sponsoring their own health plans or partnering with payors. Unfortunately for interested providers, that greater prevalence hasn’t come with any one-size-fits-all approach for making these plans succeed.

Anthem likely to leave ACA markets for 2018

Financial analysts are predicting Anthem, one of the nation’s largest health insurers, will be following other national companies in leaving the Affordable Care Act’s exchanges in 2018.

500,000 healthcare jobs added because of ACA

A new analysis from Goldman Sachs said that 500,000 of the jobs added to the healthcare sector since 2012 can be attributed to the Affordable Care Act (ACA)’s increasing of health insurance coverage. 

Cleveland Clinic operating income drops by 71%

Revenues were up at the Cleveland Clinic in 2016, but higher expenses put a damper on operating income, which fell 71 percent from the year before.

Former Anthem lobbyist to be nominated to run DOJ’s antitrust division

The specific division of the U.S. Department of Justice that fought Anthem’s $54 billion acquisition of Cigna—and which the insurers is still pushing to approve the merger over antitrust concerns—could be run by a former Anthem lobbyist.

Mayo Clinic facing state review for prioritizing privately insured patients

Mayo Clinic is being reviewed by the Minnesota Department of Human Services (DHS) for possibly breaking civil and human rights laws after comments from CEO John Noseworthy, MD, encouraging employees to prioritize commercially insured patients over Medicare and Medicaid beneficiaries.

Winners and losers in Trump’s proposed budget for HHS

President Donald Trump’s budget proposal for 2018 would reduce funding to HHS by $15.1 billion, a cut of nearly 18 percent, eliminating millions for education and training programs for healthcare professionals, while cutting $5.8 billion from the National Institutes of Health (NIH) alone.

Utilizing hospitals’ internal cost data could improve accuracy of new payment models

In an attempt to obtain greater accuracy on cost estimates, hospitals have developed their own internal systems to identify services with high and low profit margins and control spending. If what they’ve come up with is more detailed than what CMS uses, shouldn’t CMS be using that data?

Pages