Rich Daly
About the Author
Rich Daly is senior editor, policy affairs with HFMA, based in Alabama. His healthcare policy and finance reporting experience includes staff writer positions with Modern Healthcare and Congressional Quarterly (both focused on healthcare regulatory and legislative developments); editor-in-chief of 340B Report (the only news outlet focused on daily policy, legal, and business developments in the 340B program); and serving as a content director for Sg2/Vizient Inc (producing reports on financial pain points and solutions for health systems). He previously covered daily news for HFMA and wrote features for Healthcare Financial Management magazine, where his recognitions included the Stephen Barr Award (the only individual achievement award) from the American Society of Business Publication Editors.
Latest Work
Will all hospitals soon have to report their 340B revenue?
Minnesota hospitals have been required to publicly report their revenue from the 340B discount drug program, which has been described as a significant underestimate, and other states are likely to follow suit.
Hospital executives optimistic that marketplace subsidies and Medicaid supplements will endure
Financial concerns of hospital executives following the recent federal election’s outcomes centered on the fate of expiring individual market subsidies and Medicaid supplemental payments. However, executives were optimistic that both types of financial support for health systems would endure. At a post-election finance conference, Michael Marks, CFO and executive vice president of HCA Healthcare —…
One payer argues for more provider risk amid record high hospital volumes: Q&A
In January, two parts of Highmark Health — Allegheny Health Network (the provider) and Highmark (the insurer) — implemented a risk-based payment model for all of Highmark’s commercially insured groups and Medicare Advantage (MA) populations, as well as many of its Affordable Care Act marketplace plans. Bruce Meyer, MD, executive vice president and Western Pennsylvania…
Rising underinsurance rachets pressure on hospitals
The number of underinsured working-age adults in the United States has soared over the past 14 years — reaching 23% this year. And that is adding stress to hospital finances. The share of underinsured was identified in a November survey by the Commonwealth Fund, which also found: The shares of underinsured and uninsured have flipped…
Medicaid directed payments draw scrutiny, potential changes
As annual Medicaid state-directed payments (SDPSs) exceed $100 billion annually, congressional advisers are calling for transparency, while critics emphasizing the need for change. Medicaid SDPs, which primarily benefit hospitals, have surged both in their number and total spending, according to a recent staff report from the Medicaid and CHIP Payment and Access Commission (MACPAC). In…
Providence’s Deepak Sadagopan on value-based care and health system sustainability
Deepak Sadagopan of Renton, Wash.-based Providence has highlighted the ongoing labor crisis in healthcare, and the need for healthcare systems to reduce agency and increase network caregivers, while also focusing on reducing administrative needs in value-based care.
Medicare Advantage risk payment soars as hospitals left behind
Medicare Advantage (MA) has extended its payer-leading shift to downside risk but that appears to still exclude most hospitals. As of 2023, MA plans have tied 43% of payments to downside risk, which increased from 29% in 2020, according to the latest tracking from the Health Care Payment Learning and Action Network (HCP-LAN). That MA…
Two-midnight inpatient volume effect may be permanent
A boost in inpatient admissions earlier this year was expected to subside as payers clamped down but that volume shift increasingly looks permanent. Earlier in 2024, both payers and health systems reported increases in inpatient admissions — primarily among Medicare Advantage (MA) patients — following Medicare’s application of long-standing two-midnight requirements to those plans. But…
Some health systems more dependent on ACA marketplace
Patients with marketplace coverage through the Affordable Care Act (ACA) have reached the point where they contribute substantial health system revenue, raising concerns the plans may get scaled back. Marketplace enrollment hit a new record high in 2024 when more than 21 million people enrolled. That was an increase from 16 million enrollees in 2023…
Supplemental Medicaid payments drive hospitals to seek out enrollees as patients
An increasing push by states to boost Medicaid funding has led some health systems to change their views on the program to the point of now seeking its enrollees as patients. Mississippi, Nevada and North Carolina were the most recent states to obtain approval for supplemental Medicaid payments from the Centers for Medicare and Medicaid…