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Realigning Care And Coverage HFMA

(5 days ago) WebWhile the movement toward value-based care appears to be stalling out, a growing contingent of insurers and health systems are integrating coverage and care in different ways, working with each other or on their own. By …

https://www.hfma.org/guidance/healthcare-2030/realigning-care-and-coverage/

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Health Plan Resources - HFMA

(2 days ago) WebHFMA offers a collection of resources expressly designed to help health plan leaders navigate challenges and opportunities in this new era of health care.

https://www.hfma.org/guidance/health-plan-resources/

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HFMA Health System Purchase Plans 2023 HFMA

(8 days ago) WebHFMA Health System Purchase Plans 2023. Dive into an in-depth analysis on purchasing plans based on feedback from more than 300 health system executives. This report, published by HFMA and Eliciting Insights, a healthcare strategy and market research company, is a wealth of information for healthcare solution providers and investors, …

https://www.hfma.org/data-and-insights/health-system-purchase-plans/

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Healthcare Financial Management Association HFMA

(1 days ago) WebThe Buzz Monthly Newsletter Healthcare finance content, event info and membership offers delivered to your inbox. Sign up for HFMA’s monthly e-newsletter. HFMA Community Connect with fellow HFMA members in our thriving online community. Participate in discussions and start your own to solve problems, collaborate, and network. It’s never …

https://www.hfma.org/

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The Biden Administration’s Final Rule on Section 1557 …

(Just Now) WebOn April 27, 2024, the Biden Administration’s Department of Health and Human Services (HHS) finalized long-awaited revised regulations implementing Section 1557 of the Affordable Care Act (ACA

https://www.kff.org/affordable-care-act/issue-brief/the-biden-administrations-final-rule-on-section-1557-non-discrimination-regulations-under-the-aca/

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Why one New York health system stopped suing its patients

(8 days ago) WebWhy one New York health system stopped suing its patients. Noam Levey May 14, 2024. Heard on: Nationally, nearly half of adults are unable to cover a $500 medical bill without going into debt, a

https://www.marketplace.org/2024/05/14/new-york-health-system-stopped-suing-patients-medical-debt/

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Mental Health & Substance Use Disorders Medicare

(Just Now) WebMedicare covers certain screenings, services, and programs that aid in the treatment and recovery of mental health and substance use disorders. If you or someone you know is struggling or in crisis, call or text 988, the free and confidential Suicide Crisis Lifeline. You can call and speak with a trained crisis counselor 24 hours a day, 7 days

https://www.medicare.gov/coverage/mental-health-substance-use-disorder

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Medicare Advantage Penetration Plateau Provides Home Health …

(8 days ago) WebFor the first time ever, in 2023, there were more Medicare beneficiaries under an MA plan than traditional Medicare. That penetration occurred rapidly, according to data from Kaiser Family Foundation. For instance, in 2023, about 51% of beneficiaries were enrolled in MA. Just five years earlier, only 37% of beneficiaries were enrolled in MA.

https://homehealthcarenews.com/2024/05/medicare-advantage-penetration-plateau-provides-home-health-tailwind/

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Urgent care recovery plan improvements hailed HFMA

(1 days ago) WebA progress report published on NHS England’s Delivery plan for recovering urgent and emergency care has hailed the year-on-year improvements the plan has delivered. Become a member of the HFMA and join our network of healthcare finance professionals. Register Footer. About Healthcare Financial Management …

https://www.hfma.org.uk/news-alerts/urgent-care-recovery-plan-improvements-hailed

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New Jersey Chapter HFMA

(Just Now) WebThe New Jersey & Metro Philadelphia HFMA 2024 Annual Institute will be held starting October 09 th to 11 th at the Hard Rock Casino in Atlantic City. Our goal is to establish an agenda that addresses the issues of providers, payers and consumers and is timely and relevant in the emerging healthcare environment.

https://www.hfma.org/chapters/region-3/new-jersey/

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Helping hospitals and community health centers plan for resilience …

(4 days ago) WebHealth care providers and administrators are often either unaware of the opportunities and resources available through the Inflation Reduction Act or unprepared to take full advantage of them.

https://www.statnews.com/2024/05/17/hurricane-season-approaching-fast-talk-about-health-care-resilience/

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Lowell Community Health Center expands patient-care model

(5 days ago) WebSullivan, the senior director of pharmacy services, said that expanding the pharmacy space from 1,100 square feet to 1,600 square feet may facilitate prescription compliance by reducing wait times

https://www.lowellsun.com/2024/05/18/lowell-community-health-center-expands-patient-care-model/

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HHS announces national strategy to improve maternal mental …

(2 days ago) WebThe Department of Health and Human Services May 14 announced a national strategy to address maternal mental health and substance use issues. The strategy was created by the Task Force on Maternal Health, a subcommittee of the Substance Abuse and Mental Health Services Administration’s Advisory Committee for Women’s Services. …

https://www.aha.org/news/headline/2024-05-14-hhs-announces-national-strategy-improve-maternal-mental-health-care

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Former NBA player sentenced to 40 months in prison for role in …

(3 days ago) WebProfessional basketball player Glen “Big Baby” Davis, 38, has been sentenced for his role in defrauding the NBA’s healthcare plan of $5 million over a four-year period. In November of 2023, Davis was convicted of healthcare fraud and related wire fraud charges. He will now serve 40 months behind bars, followed by three years of …

https://healthexec.com/topics/healthcare-management/legal-news/former-nba-player-sentenced-40-months-prison-role-5m-healthcare-fraud-conspiracy

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NHS England delivers balanced outturn despite major cost …

(9 days ago) WebNews /. NHS England delivers balanced outturn despite major cost pressures. The NHS in England ended 2023/24 with an underspend of £30m – just 0.01% under plan, according to draft accounts. The effectively balanced position, reported in a financial performance update paper presented to the NHS England board meeting on Thursday, …

https://www.hfma.org.uk/articles/nhs-england-delivers-balanced-outturn-despite-major-cost-pressures

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Navigating toward successful contract negotiations with health …

(4 days ago) WebThe typical health system needs a rate increase of 5% to 8% each year across all payers to break even by 2027. [3] Unfortunately, successfully negotiating with payers for a common-sense rate increase can be challenging for many providers, who typically only see 1% to 3% increases over multi-year contracts. Bolstered by new …

https://www.hfma.org/payment-reimbursement-and-managed-care/payment-trends/navigating-toward-successful-contract-negotiations-with-health-plans/

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Iowa mental health, substance use system consolidation signed …

(Just Now) WebNew law consolidates mental health, substance use disorder services. Now that the bill has been signed into law, the clock is ticking for top officials at Iowa's human services agency to build up

https://www.desmoinesregister.com/story/news/politics/2024/05/15/iowa-mental-health-substance-use-system-consolidation-signed-into-law-kim-reynolds/73672968007/

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Maine Office of Child and Family Services Announces Child Care

(1 days ago) WebIt found little difference across Maine counties in the cost of providing care – approximately a 5 percent difference for child care centers and a 10 percent difference for family child care. Yet reimbursement rates vary widely; in some areas rates are up to 45 percent lower than in Cumberland County, where private pay families pay more for care.

https://www.maine.gov/dhhs/blog/maine-office-child-and-family-services-announces-child-care-reimbursement-rate-increases-2024-05-16

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Price Transparency for Health Plans - HFMA

(4 days ago) WebTo feature your health plan’s price transparency tool on this page, contact Susan Horras. Read the full report, Price Transparency in Health Care: Report from the HFMA Price Transparency Task Force (PDF format). Download Understanding Healthcare Prices: A Consumer Guide. Health plans and related organizations are encouraged to …

https://www.hfma.org/payment-reimbursement-and-managed-care/pricing/27729/

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Glen Davis: NBA champion sentenced to 40 months in prison for

(8 days ago) WebFormer NBA champion Glen Davis has been sentenced to 40 months in prison for his part in a scheme to defraud the league’s health care plan out of millions of dollars, according to federal court

https://www.cnn.com/2024/05/10/sport/glen-davis-sentenced-prison-defraud-nba-health-plan-spt-intl/index.html

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Broken teeth and infected gums: 46K claims filed so far with …

(5 days ago) WebThe public plan eventually will provide dental coverage for one in four low- and middle-income Canadian residents who don't have private dental coverage. As of May 1, eligible seniors 70 and older

https://www.cbc.ca/news/politics/canadian-dental-care-plan-claims-processed-1.7200738

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Managed Care Archives HFMA

(9 days ago) WebThe rule proposes policies that take a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service, managed care delivery… HFMA June 5, 2023 How managed care contracting strategies promote operational resilience Read this …

https://www.hfma.org/topic/payment-reimbursement-and-managed-care/managed-care/

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Healthcare Education & Events HFMA

(8 days ago) WebHFMA Live Events bring together healthcare finance professionals from all walks of life with a central focus on financial healthcare education. Attendees connect and develop strong business relationships across the healthcare industry, engage in collaborative participation and teamwork thinking, discuss issues impacting their organizations, and

https://www.hfma.org/education-events/

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From Multiple Health Plans Back to “No Plan” - HFMA

(4 days ago) WebMarch was a tumultuous time for health care with the demise—at least for now—of the American Health Care Act (AHCA). In my Eye on Washington column prior to the legislation’s quick rise and fall, I discussed various replacement bills Republicans have raised in Congress, including the Better Way released in 2016, which served as the basis …

https://www.hfma.org/payment-reimbursement-and-managed-care/healthcare-reform/53875/

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HeALTHcARe FinAnciAL MAnAgeMenT AssociATion - HFMA

(6 days ago) Webhe Healthcare Financial Management Association (HFMA) recognizes that changing the current health-care payment system is key to achieving the nation’s overall health goals of wellness, high-quality care, access to care and other societal benefit, and financial stability. HFMA’s most recent healthcare payment reform retreat,

https://www.hfma.org/wp-content/uploads/2022/10/5437.pdf

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Chapter Resources - HFMA

(3 days ago) WebChapter Resource Center. Association/Region Committees. Awards and Recognition. Chapter Leadership and Committee Rosters. Chapter Leadership Education. Chapter Portal. Chapter Resources. Operational Resources. For assistance or inquiries, email the Volunteer Experience Team .

https://www.hfma.org/chapter-resource-center/chapter-resources/

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Health Plan Payment and Reimbursement Archives HFMA

(4 days ago) WebMedicare Advantage (MA) health plans are projected to reap a 3.7% revenue increase in 2025, but provider payments could be affected by a decrease in plan benchmarks, per data shared in CMS’s annual advance notice. If finalized, the estimated 0.16% average reduction in base payments to plans could have consequences for care …

https://www.hfma.org/topic/payment-reimbursement-and-managed-care/health-plan-payment-and-reimbursement/

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Most healthcare organizations will embrace two-sided value …

(Just Now) WebAn HFMA-FORVIS survey found that although 59% of healthcare organizations plan to participate in additional two-sided risk value-based care (VBC) models, only half have clearly defined protocols (e.g., clinician sponsorship, financial projections and operational support) to assess new VBC opportunities.

https://www.hfma.org/payment-reimbursement-and-managed-care/value-based-payment/most-healthcare-organizations-will-embrace-two-sided-value-based-care-models-in-2024-but-many-do-not-have-clearly-defined-protocols-to-assess-new-opportunities/

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Certified Healthcare Financial Professional (CHFP) - HFMA

(5 days ago) WebThe CHFP is earned and awarded upon successful completion of two modules. Both modules are included with your HFMA all-access membership subscription. Step 1: Enroll in CHFP Module I – HFMA Business of Health Care ®. The HFMA Business of Health Care® online program offers participants an overview of healthcare finance, risk mitigation

https://www.hfma.org/certified-healthcare-financial-professional/

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Financial Certifications Healthcare Certifications HFMA

(3 days ago) WebHFMA’s financial certifications offer a clear path to advance your career. By knowing your skill gaps, you gain insight into your training needs. Get started, take a Career Self-Assessment, and begin mapping out your career plan. For additional questions on HFMA’s healthcare financial certifications, please email [email protected].

https://www.hfma.org/education-events/certifications/

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Membership - HFMA

(2 days ago) WebMembership Categories. No matter where you work, HFMA has a membership that’s right for you. Individuals. Professional $475. For individuals working in healthcare delivery and provider settings, including hospitals, health systems, physician practices or health plans. Join as professional. Business Partner $515.

https://www.hfma.org/membership/

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Chapters and Regions Map - HFMA

(Just Now) WebChapters and Regions Map. For assistance or inquiries, email the Volunteer Experience Team . Healthcare finance content, event info and membership offers delivered to your inbox. Sign up for HFMA’s monthly e-newslettter, The Buzz. Use this map to locate chapters in your state and region.

https://www.hfma.org/chapter-resource-center/operational-resources/chapter-and-region-map/

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Ask the Experts: Managing Health Plan Overpayments - HFMA

(4 days ago) WebAnswer 1: The rule varies from state to state. For example, Alabama is 12 months while Arkansas is 18 months, and there is not limit in Alaska. This question was answered by: David A. Williams, CPA, FHFMA, partner, Horne LLP, and a member of HFMA’s Mississippi Chapter. Answer 2: This is an issue that you can address in the …

https://www.hfma.org/payment-reimbursement-and-managed-care/health-plan-payment-and-reimbursement/53846/

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News Briefs: A new fee is set for using the No Surprises Act

(7 days ago) WebBringing out-of-network payment disputes to arbitration under the No Surprises Act in 2024 will be less expensive than previously proposed. In a final rule, the U.S. Departments of Health and Human Services, Labor and Treasury established the administrative fee for using the independent dispute resolution (IDR) portal at $115 per …

https://www.hfma.org/payment-reimbursement-and-managed-care/health-plan-payment-and-reimbursement/news-briefs-a-new-fee-is-set-for-using-the-no-surprises-act-arbitration-portal/

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Point-of-service collection goes better if the right strategies

(8 days ago) WebTo communicate overall goals and work with employees on how best to meet them, leaders should adopt a four-step goal-setting approach: 1. Determine the starting point. Review where the collectors are today in relation to department collection goals and where they should ideally be. 2.

https://www.hfma.org/revenue-cycle/billing-and-collections/point-of-service-collection-goes-better-if-the-right-strategies-and-tactics-are-employed/

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