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A bonus of up to 10 percent has been proposed for using an upgraded electronic health record (EHR) system for reporting in the Merit-based Incentive Payment System (MIPS) in 2018, but speakers at two recent industry conventions warned it’s likely not a worthwhile investment for providers.

When the previous administration at CMS finalized rules on mandatory bundled payment models for cardiac and orthopedic care late in 2016, 221 public comments were received. The cancellation of those same bundles, however, drew only 85 official comments as of Oct. 18.

Four accountable care organization (ACO) models generated more in gross savings in 2016, but unlike in previous years, CMS hasn’t publicly touted the results as it re-examines payment models created under the Centers for Medicare and Medicaid Innovation (CMMI).

The U.S. Department of Justice (DOJ) has abandoned a lawsuit against UnitedHealth over allegations the insurer submitted false claims in its Medicare Advantage plans, though a similar case remains active.

Private investors are becoming increasingly active in healthcare acquisitions, which may maximize the purchase price when practices decide to sell, but there are downsides to these transactions compared to be absorbed into a hospital or health system.

 

Recent Headlines

919,000 healthcare jobs could be lost under Senate healthcare bill

The Better Care Reconciliation Act (BCRA) would eliminate one of every 22 healthcare jobs by 2026, according to a new study from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund.

Q&A with TransUnion execs: Patients are the new payers

One of the most frequently discussed topics from the Healthcare Financial Management Association (HFMA) conference was the need to increase patient engagement when it comes to payment as out-of-pocket costs and deductibles continue to rise.

Billionaire doctor Patrick Soon-Shiong to take over 6 California hospitals

NantWorks, the company run by billionaire Patrick Soon-Shiong, MD, will take over operations at six California hospitals after acquiring controlling interest in Integrity Healthcare, the management company of Verity Health System.

Wasteful healthcare spending can’t be pinned on end-of-life care

Reducing medical spending in the last year of a patient’s life isn’t a panacea for limiting growth in overall healthcare costs, according to a study published in the July 2017 issue of Health Affairs.

Providers won’t be able to avoid downside risk much longer

Among hundreds of healthcare finance professionals at a Healthcare Financial Management Association (HFMA) conference presentation, no one could say their systems were taking on downside risk above 5 percent of their total revenue. Francois de Brantes, MS, MBA, vice president of director of the Altarum Institute’s Center for Payment Innovation, said that needs to change.

Aetna moving to New York from Connecticut

Aetna has confirmed its moving its corporate headquarters out of Hartford, Connecticut and into New York City, which offered a package of property and sales tax breaks worth nearly $34 million.

HFMA 2017: Hospital finance execs have ‘significant lack of knowledge’ around MACRA

Nearly halfway through the first year of Medicare Access and CHIP Reauthorization Act’s (MACRA) new payment tracks and hospital, a majority of hospital finance executives and professionals say understand the requirements of the new Quality Payment Program (QPP) but, in reality, still seem to be confused.

Epic to launch medical billing unit later in 2017

Electronic health record giant Epic is now expanding into medical billing space, according to a new job listing posted on its website.

HFMA 2017: 2 out of 3 patients don’t pay their hospitals bills in full

68 percent of patients with hospital bills under $500 didn’t pay off the full balance by the end of 2016, according a TransUnion Health study released at the Healthcare Financial Management Association (HFMA) conference in Orlando.

HFMA 2017: ACA repeal bills pose credit risk to hospitals

Whether Republicans’ version of an Affordable Care Act repeal-and-replace bill looks like the House-passed American Health Care Act (AHCA) or the Senate’s Better Care Reconciliation Act (BCRA), it would have a negative impact on the credit ratings of nonprofit hospitals, according to Fitch Ratings.

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