Health Plan Resources

A collection of resources to help health plan leaders navigate the challenges and opportunities in this new era of health care.

Resources

Blog | Value-Based Payment

Medicare Advantage concepts come to Medicare fee-for-service with Geographic Direct Contracting Model
While the MA Stars Rating program is a bonus program where plans can earn additional revenue for achieving high scores, quality in the Geographic Direct Contracting program is treated more like a penalty, says HFMA's Chad Mulvany.
By Chad Mulvany, FHFMA
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Trend | Social Determinants of Health

SDOH: An emerging population health priority
In recent years, public health and not-for-profit organizations have focused on addressing social determinants of health (SDOH) and their impact on individuals’ wellness and ability to access healthcare services. Progress has been slow to d...
By Pam Nicholson, MBA, and Dudley Morris
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Blog | Payment Models

Connecticut’s launch of a bundled payment program for its employee health plan is part of an effort to save the state $185 million
HFMA’s Chad Mulvany says some state governments, like Connecticut, have high enough volumes that COVID-19 may accelerate their adoption of value-based payment models.
By Chad Mulvany, FHFMA
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News | Value-Based Payment

CMS unveils the Geographic Direct Contracting model
The Geographic Direct Contracting model will test full-risk arrangements for healthcare entities serving thousands of Medicare beneficiaries within defined geographic areas.
By Rich Daly, HFMA Senior Writer and Editor
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News | Medicare Payment and Reimbursement

Medicare phases out the inpatient-only list, backs off further 340B payment cuts
The final rule for the CY21 Medicare Outpatient Prospective Payment System will phase out the inpatient-only list but won’t implement steeper 340B cuts.
By Rich Daly, HFMA Senior Writer and Editor
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News | Value-Based Payment

Stark, Anti-Kickback changes draw praise from providers
Final rules modifying enforcement of the Stark Law and the Anti-Kickback Statute aim to remove barriers to participation in value-based payment models.
By Rich Daly, HFMA Senior Writer and Editor
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Blog | Value-Based Payment

Medicare Advantage concepts come to Medicare fee-for-service with Geographic Direct Contracting Model
While the MA Stars Rating program is a bonus program where plans can earn additional revenue for achieving high scores, quality in the Geographic Direct Contracting program is treated more like a penalty, says HFMA's Chad Mulvany.
By Chad Mulvany, FHFMA
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Blog | Payment Models

Connecticut’s launch of a bundled payment program for its employee health plan is part of an effort to save the state $185 million
HFMA’s Chad Mulvany says some state governments, like Connecticut, have high enough volumes that COVID-19 may accelerate their adoption of value-based payment models.
By Chad Mulvany, FHFMA
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Blog | Healthcare Reform

Post-election Washington policy outlook on health policy priorities

HFMA's Chad Mulvany speculates on health policy priorities and changes in the next 24 months, assuming we continue to have a divided government and President-elect Biden's campaign survives President Trump's many legal challenges about stat...
By Chad Mulvany, FHFMA
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