Category Archives: Managed Care

Emerging Medicaid ACOs: A State Experiment, One Year In

By | March 20, 2019

We hope you can join us on March 28th for the Health Care Delivery Transformation Committee’s first annual meeting, “Transformation or Disruption: Changing the Focus and Pace of Change in Healthcare Delivery.”  In the post below, Katherine Record discusses the transformative change in the MassHealth Program, one of the many topics to be covered at the meeting.  Last year,… Read More »

Are you curious about Value-based Care?

By | March 17, 2019

If you are interested in learning more about Value Based Care (VBC), join HFMA at the upcoming Health Care Delivery Transformation conferenceon March 28th. Joshua Mast, Senior Regulatory Strategist at Cerner will provide an introduction and foundation to this topic. He will be demystifying the alphabet soup of VBC, at a high level.  Joshua joined Cerner in September… Read More »

Transformation or Disruption? Registration is Open for Our Newest Conference

By | February 13, 2019

We are excited to announce that registration is now open for “Transformation or Disruption: Changing the Focus and Pace of Change in Healthcare Delivery.”  This conference is brought to you by our newly merged Healthcare Delivery Transformation Committee (formerly the EPM/PPM and Managed Care Committees).  The conference will take place on March 28, 2019 at the Four Points by… Read More »

Drug Pricing and Payment Policy: Key 2018 Developments and Potential 2019 Changes and Challenges

Following a number of drug pricing reforms implemented or proposed in 2018, 2019 likely will bring more action from HHS and Congress to reduce drug prices. Key Points: In 2018, the Administration implemented and proposed several policy changes to reduce drug prices or spending, and Congress passed new legislation prohibiting health plans from preventing pharmacies from informing plan… Read More »

Get Registered for Fall Educational Programs Today

By | October 24, 2018

Our chapter has a full schedule in November!  With two in-person programs and one webinar in before Thanksgiving, there’s something on the agenda for everyone. Capital Finance Seminar: Debt Management and Risk Management–From Basic to Complex November 1–Bank of America Merrill Lynch, 225 Franklin Street, Boston, MA 02110 Join us for an afternoon program highlighting debt finance and enterprise… Read More »

Introducing HFMA’s “Healthcare Delivery Transformation Committee!”

This fall two of the HFMA MA-RI Chapter’s Committees, the Enterprise Performance Management / Physician Practice Management Committee and the Managed Care Committee merged to form the newly founded “Healthcare Delivery Transformation Committee.”  The merger is a result of the changing healthcare delivery landscape; there are far more similarities than differences among the operational and financial concerns of managed… Read More »

New to Healthcare Seminar Registration Open

By | August 8, 2018

The Massachusetts-Rhode Island Chapter will be hosting its annual New to Healthcare Seminar on Friday, September 21, 2018 at Suffolk Law School.  Join us for a great day of healthcare finance basics from leaders in the industry.  The day’s topics include: Fundamentals of Healthcare Finance and Reporting (Erik Lynch, BDO USA LLP) Law, Compliance and Regulations (Timothy Hogan,… Read More »

CMS Focuses on a Modern Medicare in New Proposed Rules

Earlier this month, CMS proposed changes to the Medicare Physician Fee Schedule (the “PFS Proposed Rule“) and Quality Payment Program (the “QPP Proposed Rule“) with the goal of “modernizing Medicare and restoring the doctor-patient relationship.” The proposed changes achieve this goal by streamlining the billing process and reducing the amount of paperwork providers face, empowering providers to maximize use of electronic health record systems, and… Read More »

Value in Managing Chronically Ill Patients

By | July 18, 2018

The Center for Medicare and Medicaid Services (CMS) launched the Chronic Care Management (CCM) program in January 2015. The introduction of CPT code 99490 allowed provider led teams to remotely manage the health of their sickest patients. Medicare fee-for-service beneficiaries with two or more chronic conditions among the twenty seven outlined by CMS (source) may be enrolled, after… Read More »