News Briefs: Hospital advocates bemoan the small Medicare payment increase proposed for FY25
The payment update described in Medicare’s FY25 proposed rule for inpatient hospital care and long-term care hospitals falls well short of what hospitals need to keep up with costs, advocates say. The inpatient payment rate would rise by 2.6% for hospitals that fulfill quality-reporting requirements and meet the criteria to be designated as meaningful users…
Navigating toward successful contract negotiations with health plans
A group of healthcare leaders discuss various tactics they are using to negotiate better rates with payers and ensure payers’ commitment to accurate, timely payment.
Geeta Nayyar: Healthcare industry needs to take charge in refuting misinformation
In the early months of the COVID-19 pandemic, Geeta Nayyar, MD, MBA, found herself captivated by the misinformation — and disinformation — spewed across social media. People were falling prey to lies, conspiracy theories and snake-oil hucksters, and in some cases, the bad advice killed them. The environment reminded her of another deadly misinformation crisis…
Not-for-profit health systems need a new enterprise strategy
Not-for-profit (NFP) health systems raises concerns over their long-term financial viability. The research findings underscore the need for NFP health system leaders to reconceptualize their organization as comprising six strategic business units (SBUs) and then manage each in terms of competitiveness. Research findings identify NFP financial challenges The research sought to quantify the operating performance…
Shawn Stack: The value of revisiting policies and processes for financial assistance
The charity care processes adopted by healthcare providers have attracted criticism in media stories focusing on the high cost of care. On a recent episode of HFMA’s “Voices in Healthcare Finance” podcast, HFMA Policy Director Shawn Stack discussed the value of revisiting financial assistance policies and processes. Below is an excerpt from the interview. Erika…
Why the Medicare physician fee schedule is sheer madness
Amid the complexities of U.S. healthcare, there is probably no construct that’s more byzantine than the Medicare Physician Fee Schedule (MPFS) — the program’s elaborate system of paying physicians and other clinicians (including nurse practitioners, physician assistants and clinical psychologists) for more than 10,000 medical services.a In 2022, the schedule drove about $71.2 billion in…
Reimagining charity care
Depak Manmohan Goyal, MD, MBBS, MBA, executive director for revenue cycle and supply chain at Monument Health, remembers the case of a 40-year-old patient with late-stage cancer who sought care at the Rapid City, S.D., health system a few years ago before succumbing to her disease. An earlier and unrelated care episode ideally would have…
Healthcare Blame Game: New York Times medical debt piece dubbed ‘laziest story of the year,’ plus revisiting charity care policies
Brad examines a New York Times article by investigative reporter Sarah Kliff about a recent study of patients whose debt was eliminated by RIP Medical Debt. Researchers say the results surprised them.
Robert Rebitzer: How to overcome the disruptive forces that can impede high-value innovation
In the 1980s, two valuable innovations, laparoscopic gallbladder surgery and electronic health records (EHRs), came to market. The former became widely adopted in about three years. The latter took three decades and billions of dollars in federal subsidies. The reasons behind the differing uptakes of health innovation are among the topics in the book Why…
A year after Silicon Valley Bank’s collapse, what have we learned about managing counterparty risk?
On March 8, 2023, Silicon Valley Bank (SVB) announced a $1.8 billion loss from the sale of securities to cover a decline in clients’ deposits. The following day, SVB’s stock dropped 60% and the bank saw a historic $42 billion in withdrawal requests. Twenty-four hours later, SVB was under the control of U.S. banking regulators…